Remote Dental PPO Network Discount Senior Analyst

CVS Health; Alton (IL); Teletrabalho; USD 47 000 - 122 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Resumo da oferta

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the United States. You will analyze provider reimbursement arrangements, identify opportunities, and lead fee schedule renegotiations and network rebalancing strategies.

The role requires strong dental insurance knowledge, market dynamics, and provider economics. You will leverage claims and market data to drive recommendations while maintaining network adequacy and member access, with mostly remote

Qualificações

• Minimum of 3 years in provider network management or payer environment.
• 5+ years in the dental industry, including PPO, DMO, Medicare or related products.
• Strong analytical and problem-solving skills with the ability to translate data into actionable strategies.
• Proficiency in data analysis and experience working with claims or reimbursement data.

Responsabilidades

• Analyze provider reimbursement arrangements, claims data, and network performance metrics.
• Lead provider fee schedule negotiations and network optimization initiatives.
• Evaluate market conditions and contracting strategies.
• Assess financial and operational impact of reimbursement changes.
• Collaborate with network management, contracting, analytics, provider relations, and product teams.
• Build relationships with dental providers and provider groups to facilitate negotiations.
• Present data-driven recommendations and business cases to leadership.

Conhecimentos

Analytical thinking

Negotiation

Data analysis

Healthcare reimbursement

Dental industry knowledge

Provider contracting

Relationship building

Data visualization

Descrição da oferta de emprego

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the United States. You will analyze provider reimbursement arrangements, identify opportunities, and lead fee schedule renegotiations and network rebalancing strategies.

The role requires strong dental insurance knowledge, market dynamics, and provider economics. You will leverage claims and market data to drive recommendations while maintaining network adequacy and member access, with mostly remote