Senior Investigator (Dental, Aetna SIU)

Clinical Careers Page(1 month ago)

MichiganOnsiteFull TimeSenior$46,988 - $102,000Special Investigations Unit

About this role

Senior Healthcare Fraud Investigator at CVS Health (Aetna) focused on dental investigations within the Special Investigations Unit. The role centers on managing complex cases of suspected healthcare fraud, waste and abuse and coordinating with internal and external partners. The position supports legal and regulatory referrals and contributes to recovery efforts and prosecution when appropriate.

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Required Skills

Investigations
Case Documentation
Legal Review
Research
Microsoft Word
Excel
Outlook
Open Source
Social Media
Internet Research

+5 more

Qualifications

Bachelor's in Criminal Justice
Bachelor's in Healthcare Management
Bachelor's in Public Health
Bachelor's in Biological Sciences
Bachelor's in Data and Analytics
CPC
AHFI
CFE

About Clinical Careers Page

cvshealth.com

CVS 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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