Remote Dental PPO Network Optimization Analyst

CVS Health Corporation; Kansas; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health Corporation in the United States is seeking a Senior Analyst, PPO Network Discount Optimization to strengthen Aetna Dental’s provider networks by driving PPO discount improvements nationwide.

The role involves analyzing reimbursement arrangements, leading fee schedule negotiations, and developing network rebalancing strategies with cross-functional teams. Remote work is primary with travel as needed.

Qualifications

• Minimum of 3 years of experience in provider network management, sales, provider relations, customer service, healthcare reimbursement, dental practice operations, or a payer environment.
• Strong analytical and problem-solving skills with the ability to interpret complex data and translate findings into actionable strategies.
• Proven negotiation, influencing, and relationship-building capabilities.
• Excellent verbal, written, and presentation communication skills.
• Proficiency in data analysis and experience working with claims or reimbursement data.

Responsibilities

• Analyze provider reimbursement arrangements, claims data, and network performance metrics to identify opportunities for PPO discount improvement.
• Lead provider fee schedule negotiations and network optimization initiatives that support organizational financial goals.
• Evaluate market conditions, competitive dynamics, and provider-specific factors to develop targeted contracting strategies.
• Assess the financial and operational impact of proposed reimbursement changes and network adjustments.
• Collaborate with internal stakeholders across network management, contracting, analytics, provider relations, and product teams.
• Build and maintain productive relationships with dental providers and provider groups to facilitate successful negotiations.
• Present data-driven recommendations and business cases to leadership and key stakeholders.

Skills

Analytical thinking

Negotiation

Relationship management

Data analysis

Communication skills

Presentation skills

Claims data

Healthcare reimbursement

Provider contracting

Fee schedule

Education

Associate's degree

Job description

CVS Health Corporation in the United States is seeking a Senior Analyst, PPO Network Discount Optimization to strengthen Aetna Dental’s provider networks by driving PPO discount improvements nationwide.

The role involves analyzing reimbursement arrangements, leading fee schedule negotiations, and developing network rebalancing strategies with cross-functional teams. Remote work is primary with travel as needed.