Manager, Special Investigations Unit - Healthcare Fraud

Location: Michigan

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, 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 The 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 Hours
40

Time Type Full time

Pay Range The typical pay range for this role is:$54,300.00 - $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.

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 Benefits Moments.

We anticipate the application window for this opening will close on: 08/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.