Remote PPO Network Optimization Analyst

CVS Health Corporation; Washington; Hybride; USD 47 000 - 122 000; Plein temps

Résumé du poste

CVS Health Corporation is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the U.S. The role focuses on analyzing reimbursement and network performance, negotiating fee schedules, and balancing network adequacy with member access.

The position is primarily remote, with occasional travel, and requires strong analytics, stakeholder management, and strategic contracting capabilities to drive financial and operational objectives.

Qualifications

• Minimum 3 years in provider network management or related healthcare reimbursement roles.
• 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.
• Experience working with claims or reimbursement data.

Responsabilités

• 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.

Connaissances

Analytical skills

Negotiation

Communication skills

Relationship management

Data interpretation

Formation

Associate's degree or equivalent

Outils

Data visualization software

Claims data systems

Description du poste

CVS Health Corporation is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the U.S. The role focuses on analyzing reimbursement and network performance, negotiating fee schedules, and balancing network adequacy with member access.

The position is primarily remote, with occasional travel, and requires strong analytics, stakeholder management, and strategic contracting capabilities to drive financial and operational objectives.