SIU Lead - Fraud Analytics & Investigation

CVS Health Corporation; Oklahoma City (OK); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Fraud, Waste, and Abuse (FWA) Analyst II to identify healthcare fraud leads through data mining and claims analysis. You will translate complex data into actionable investigative leads and recommendations while partnering with SIU and compliance teams.

The role requires strong analytical skills, 3+ years in healthcare data analysis, and up to 10% travel. The position is full-time, based in the United States, with a competitive benefits package and bonus eligibility.

Qualifications

• 3+ years of healthcare data analysis, SIU, claims analysis, or fraud experience.
• Strong analytical and critical-thinking skills to identify trends.
• Experience interpreting large healthcare datasets.

Responsibilities

• Develop lead summaries with allegations and risk indicators.
• Present findings to SIU leadership and investigators.
• Escalate findings to investigations or closures as appropriate.
• Collaborate with investigators, clinicians, and compliance teams.

Skills

Healthcare data analysis

SIU experience

Claims analysis

Auditing

Payment integrity

Healthcare fraud experience

Education

Bachelor's degree

Tools

Tableau

SQL

JIRA

Power BI

SAS

Job description

CVS Health is seeking a Fraud, Waste, and Abuse (FWA) Analyst II to identify healthcare fraud leads through data mining and claims analysis. You will translate complex data into actionable investigative leads and recommendations while partnering with SIU and compliance teams.

The role requires strong analytical skills, 3+ years in healthcare data analysis, and up to 10% travel. The position is full-time, based in the United States, with a competitive benefits package and bonus eligibility.