Remote PPO Dental Network Optimization Analyst

CVS Health; Sioux Falls (SD); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical Insurance

Dental Coverage

Vision Coverage

Paid Time Off

Retirement Savings

Wellness Programs

Job summary

CVS Health, including its Aetna Dental network, is seeking a Senior Analyst to optimize PPO discounts nationwide. The role analyzes provider reimbursement, negotiates fee schedules, and guides network rebalancing to strengthen competitiveness while maintaining provider access.

Ideal candidates have deep dental network experience, strong data analytics, and proven negotiation skills to influence provider participation and drive financial and operational results across the national network.

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.
• Proficiency in data analysis and experience working with claims or reimbursement data.
• 5+ years of experience within the dental industry, including familiarity with PPO, DMO, Medicare, and other dental network products.

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

Data Analysis

Contract Negotiation

Financial Acumen

Process Improvement

Job description

CVS Health, including its Aetna Dental network, is seeking a Senior Analyst to optimize PPO discounts nationwide. The role analyzes provider reimbursement, negotiates fee schedules, and guides network rebalancing to strengthen competitiveness while maintaining provider access.

Ideal candidates have deep dental network experience, strong data analytics, and proven negotiation skills to influence provider participation and drive financial and operational results across the national network.