Senior Investigator (Aetna SIU)
Clinical Careers Page(1 month ago)
About this role
A Senior Investigator at CVS Health focuses on complex healthcare fraud and abuse investigations, primarily within Medicaid. The role handles sensitive, multi-jurisdictional cases and works with internal and external partners to protect company and customer funds. West Virginia residency is required for this position.
Required Skills
- Medical Coding
- Excel
- Data Mining
- Investigations
- Research
- Communication
- Clinical Review
- Testimony
Qualifications
- Bachelor's Degree Or Equivalent Experience
- CFE (Association Of Certified Fraud Examiners)
- AHFI Accreditation (National Health Care Anti-Fraud Association)
About Clinical Careers Page
cvshealth.comCVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.
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