Director, Special Investigations Unit
CVS Health Corporation, Hartford, CT, United States
Director, Special Investigations Unit page is loaded## Director, Special Investigations Unitremote type:
Hybridlocations:
CT - Hartfordtime type:
Full timeposted on:
Posted Todaytime left to apply:
End Date: May 3, 2026 (4 days left to apply)job requisition id:
R0896638We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health(R), you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.**Position Summary**
Reporting to the SIU Executive Director, the Investigative Lead Director is responsible to detect, investigate, and mitigate Fraud, Waste and abuse across our Commercial and Medicare business lines.**Activities Include:*** Oversight of multiple teams within the Special Investigations Unit, including Managers, Investigators, and investigative program management.* Program management of SIU policies, procedures, and practices ensuring compliant and efficient workflows.* Provides guidance to and ensures training for Managers and investigators regarding obtaining evidence, sufficiency of evidence, investigative interviews, and other investigatory techniques and practices.* Coordinates with state and federal law enforcement regarding matters under investigation* Identifies potential investigative issues, subjects, and targets.* Provides guidance on investigative and litigation strategies and issues; troubleshoots with staff to identify solutions.* Develops expertise in applicable laws, rules, regulations, and other standards related to investigative procedures and advises on the application of federal and state laws governing fraud, waste, and abuse.* Communicates with various internal and external stakeholders, including representatives from state and federal government and the healthcare industry.* Maintains effective oversight of investigative activity ensuring timeliness and quality.**Required Qualifications*** 10 or more years of experience in leading healthcare fraud investigative teams* Experience with litigation and criminal or civil investigations in a leadership capacity* Excellent writing skills with an ability to draft, edit, and analyze investigative findings, reports, and claim data.* Excellent public speaking skills**Preferred Qualifications*** Accredited Healthcare Fraud Investigator [AHFI] and/or Certified Fraud Examiner [CFE]**Education*** Bachelors or Master’s degree or equivalent experience required**Pay Range**The typical pay range for this role is:$100,000.00 - $231,540.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.**Great benefits for great people**We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full‐time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‐being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on .We anticipate the application window for this opening will close on: 05/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Hybridlocations:
CT - Hartfordtime type:
Full timeposted on:
Posted Todaytime left to apply:
End Date: May 3, 2026 (4 days left to apply)job requisition id:
R0896638We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health(R), you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.**Position Summary**
Reporting to the SIU Executive Director, the Investigative Lead Director is responsible to detect, investigate, and mitigate Fraud, Waste and abuse across our Commercial and Medicare business lines.**Activities Include:*** Oversight of multiple teams within the Special Investigations Unit, including Managers, Investigators, and investigative program management.* Program management of SIU policies, procedures, and practices ensuring compliant and efficient workflows.* Provides guidance to and ensures training for Managers and investigators regarding obtaining evidence, sufficiency of evidence, investigative interviews, and other investigatory techniques and practices.* Coordinates with state and federal law enforcement regarding matters under investigation* Identifies potential investigative issues, subjects, and targets.* Provides guidance on investigative and litigation strategies and issues; troubleshoots with staff to identify solutions.* Develops expertise in applicable laws, rules, regulations, and other standards related to investigative procedures and advises on the application of federal and state laws governing fraud, waste, and abuse.* Communicates with various internal and external stakeholders, including representatives from state and federal government and the healthcare industry.* Maintains effective oversight of investigative activity ensuring timeliness and quality.**Required Qualifications*** 10 or more years of experience in leading healthcare fraud investigative teams* Experience with litigation and criminal or civil investigations in a leadership capacity* Excellent writing skills with an ability to draft, edit, and analyze investigative findings, reports, and claim data.* Excellent public speaking skills**Preferred Qualifications*** Accredited Healthcare Fraud Investigator [AHFI] and/or Certified Fraud Examiner [CFE]**Education*** Bachelors or Master’s degree or equivalent experience required**Pay Range**The typical pay range for this role is:$100,000.00 - $231,540.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.**Great benefits for great people**We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full‐time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‐being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on .We anticipate the application window for this opening will close on: 05/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr