• Quality Reviewer ( Aetna

    CVS Health (Washington, DC)
    …affordable. **Position Summary** + Assess the thoroughness and accuracy of investigations aimed at preventing payment of fraudulent claims by insured individuals, ... + Analyze and prepare cases for clinical and legal review , ensuring all documentation meets required standards. + Document...resources and the best course of action for ongoing investigations . + Work with federal, state, and local law… more
    CVS Health (12/07/24)
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  • Special Investigation Unit Manager…

    CVS Health (Washington, DC)
    …innovate and deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our ... with regulatory requirements. The Manager develops strategies to manage workload, quality of reviews and process improvements. **Responsibilities:** Lead and mentor… more
    CVS Health (12/25/24)
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