Dental PPO Network Optimization Senior Analyst

CVS Health; Beryl (WV); Remote; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental. You will analyze provider reimbursement, market data, and network performance to drive improvements while ensuring network adequacy and member access.

This role is remote and full-time, offering cross-functional collaboration with network management, contracting, analytics, and provider relations. You will lead fee schedule negotiations and strategy development based on market dynamics.

Qualifications

• Minimum 3 years experience in provider network management or payer environments.
• Strong analytical and problem-solving skills to translate data into actions.
• Proven negotiation, influencing, and relationship-building capabilities.
• Experience with claims or reimbursement data.
• 5+ years in the dental industry including PPO, DMO, Medicare.
• Knowledge of provider contracting and fee schedules.
• 1–3 years of financial analysis or healthcare economics.
• Experience using data visualization and reporting tools.

Responsibilities

• Analyze provider reimbursement and network data to identify PPO discount improvement opportunities.
• Lead provider fee schedule negotiations and network optimization initiatives.
• Evaluate market conditions and provider factors to develop contracting strategies.
• Assess financial and operational impact of proposed reimbursement changes.
• Collaborate with network management, contracting, analytics, provider relations, and product teams.
• Build relationships with dental providers to facilitate negotiations.
• Present data-driven recommendations and business cases to leadership.

Skills

Data analysis

Contract negotiation

Financial acumen

Process improvement

Data visualization

Tools

Data visualization tools

Job description

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental. You will analyze provider reimbursement, market data, and network performance to drive improvements while ensuring network adequacy and member access.

This role is remote and full-time, offering cross-functional collaboration with network management, contracting, analytics, and provider relations. You will lead fee schedule negotiations and strategy development based on market dynamics.