Position SummaryThe Manager of the Special Investigations Unit is responsible for leading investigative work related to potential fraud, waste, and abuse across health care claims, provider activity, and related operational and/or compliance concerns. This role manages day-to-day investigative workflows, supports the development of staff, and helps ensure investigations are conducted thoroughly, consistently, and in alignment with organizational standards and regulatory expectations.
This leader plays an important role in translating investigative priorities into clear team direction, monitoring case progress, identifying risks, and elevating significant findings to leadership and stakeholders as appropriate. This position requires strong judgment, analytical rigor, and the ability to balance quality, timeliness, and accountability in a highly sensitive environment.
Required Qualifications- Minimum of two years of experience in health care fraud, waste, and abuse investigations, special investigations, compliance, audit, or a related field
- Minimum of 5 years of investigative work experience.
- Experience leading or coordinating investigative teams, workflows, and complex case activity
- Strong analytical, problem-solving, and decision-making skills
- Strong written and verbal communication skills, including the ability to summarize complex findings clearly
- Ability to manage sensitive information with professionalism and discretion
- Experience working across cross-functional teams in a regulated environment
- Knowledge of investigative practices, documentation standards, and risk-based decision-making
Preferred Qualifications- CFE, AHFI, or CPC certification
- Experience with Medicaid investigations and regulatory requirements
- Advanced analytical skills
- Ability to apply critical thinking and sound judgment to complex issues
- Strong ability to think innovatively and develop solutions to improve efficiency, quality, and team performance
Education- Bachelor's degree in criminal justice, finance, business administration, or a related field
Anticipated Weekly Hours40
Time TypeFull time
Pay RangeThe typical pay range for this role is:
$54,300.00 - $159,120.00
This 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.
Great benefits for great peopleWe 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 Benefits Moments.
We anticipate the application window for this opening will close on: 08/14/2026
