Senior Analyst, Special Investigation Unit

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.The Senior RFI Analyst within the Special Investigations Unit (SIU) plays a key role in supporting fraud, waste, and abuse investigations by managing and responding to Requests for Information (RFIs) from regulatory agencies, law enforcement, and internal stakeholders. This position ensures timely, accurate, and compliant delivery of sensitive data and documentation across multiple lines of business and jurisdictions. The analyst collaborates closely with investigative teams, legal, compliance, and operational departments to maintain transparency and accountability in all RFI-related activities.In addition to core responsibilities, the Senior RFI Analyst will support Training, Quality, and Program Integrity (PI) initiatives by pulling and analyzing relevant data, identifying trends, and contributing to the development of best practices. The analyst will also provide leadership support to the Manager by assisting with team coordination, reporting, and strategic planning efforts.

Required Qualifications

• 5+ years of experience in healthcare investigations, compliance, or data analysis (or equivalent professional experience)
• Strong understanding of PHI/PII handling and regulatory requirements (e.g., HIPAA, CMS, state-specific guidelines)
• Excellent written and verbal communication skills
• Proficiency in Microsoft Excel, SharePoint, and case management systems
• Ability to work independently and collaboratively in a fast-paced environment
• Experience supporting training, quality, or process improvement efforts

Preferred Qualifications

- Experience working with Medicaid and Medicare programs
- Familiarity with state-specific fraud investigation protocols (e.g., Texas OIG, Florida AHCA)
- Prior experience in a SIU or regulatory response role
- Knowledge of claims processing, provider contracting, and credentialing workflows
- Project management or process improvement experienceEducation

Bachelor's degree in a relevant field such as Criminal Justice, Healthcare Administration, Business, or a related discipline. Equivalent professional experience may be considered in lieu of a formal degree. Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$46,988.00 - $112,200.00This 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.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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 11/07/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Hartford, CT

Job ID: CVS-R0694545

Employment Type: FULL_TIME

Posted: 2025-09-13T19:42:18