Manager, Special Investigations Unit

CVS Health Careers

. Lead investigative work related to potential fraud, waste, and abuse across health care claims, provider activity, and related operational and compliance concerns .

Posted 11/12/2026full-timeSpringfield • Illinois • United StatesMid-LevelSenior💰 $54,300 - $145,860 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in health care fraud, waste, and abuse investigations, with a strong focus on compliance and risk management. Proven ability to lead investigative teams, manage workflows, and communicate complex findings effectively.

Highest-signal resume keywords

Health Care Fraud InvestigationsLeadership ExperienceAnalytical SkillsRisk-Based Decision-MakingWritten And Verbal Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Investigative PracticesDocumentation StandardsComplianceAuditCase ManagementProblem-SolvingDecision-MakingWorkflow CoordinationRegulatory KnowledgeRisk Identification

Soft Skills

ProfessionalismDiscretionTeam CollaborationAccountabilityCommunication

Industry Keywords

Health Care ClaimsFraudWasteAbuseOperational ConcernsCompliance StandardsInvestigative WorkflowsCross-Functional TeamsSensitive Information ManagementCriminal Justice

About the role

Key responsibilities & impact

Lead investigative work related to potential fraud, waste, and abuse across health care claims, provider activity, and related operational and compliance concerns
Manage day-to-day investigative workflows
Support the development of staff
Ensure investigations are conducted thoroughly, consistently, and in alignment with organizational standards and regulatory expectations
Translate investigative priorities into clear team direction
Monitor case progress
Identify risks
Elevate significant findings to leadership and stakeholders as appropriate
Balance quality, timeliness, and accountability in a highly sensitive environment

Requirements

What you’ll need

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
3+ years of leadership experience managing 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
Bachelor’s degree in criminal justice, finance, business administration, or a related field

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being, based on eligibility
CVS Health bonus, commission or short-term incentive program in addition to base pay