Government Careers

  • Fraud Investigator

  • Devoted Health Services
  • Waltham, Massachusetts 02453 United States View Map

Summary

Devoted Health is seeking a Pharmacy Fraud Program Manager within the Special Investigations Unit. You will own the CFWA relationship with CVS, validate and reconcile data from pharmacy claims and PBM feeds, and use AI-assisted tools to prioritize and investigate suspected fraud.You will collaborate across claims, compliance, legal, and analytics to strengthen controls and produce clear findings. You will bring deep pharmacy depth, experience with NCPDP/NDC data, and a proactive, questioning#J-18808-Ljbffr

Job Description

Devoted Health is seeking a Pharmacy Fraud Program Manager within the Special Investigations Unit. You will own the CFWA relationship with CVS, validate and reconcile data from pharmacy claims and PBM feeds, and use AI-assisted tools to prioritize and investigate suspected fraud.You will collaborate across claims, compliance, legal, and analytics to strengthen controls and produce clear findings. You will bring deep pharmacy depth, experience with NCPDP/NDC data, and a proactive, questioning#J-18808-Ljbffr

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