Remote PPO Network Optimization Analyst – Dental

4062 Aetna Resources, LLC; Town of Texas (WI); Hybrid; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources (based on eligibility)

Job summary

CVS Health/Aetna Dental is seeking a Senior Analyst to optimize PPO network discounts across the U.S. by analyzing provider reimbursements and renegotiating fee schedules. This role emphasizes data-driven strategy and cross-functional collaboration within a national network.

You will lead contracting strategies, assess market conditions, and work with network management, analytics, and provider relations teams. Remote work is primary with occasional travel.

Qualifications

• 3+ years in provider network management or healthcare reimbursement roles.
• Strong analytical and problem-solving skills to interpret complex data.
• Proven negotiation, influencing, and relationship-building capabilities.
• Excellent verbal, written, and presentation communication skills.
• 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 building

Communication

Data analysis

Education

Associate's degree

Tools

Data visualization tools

Job description

CVS Health/Aetna Dental is seeking a Senior Analyst to optimize PPO network discounts across the U.S. by analyzing provider reimbursements and renegotiating fee schedules. This role emphasizes data-driven strategy and cross-functional collaboration within a national network.

You will lead contracting strategies, assess market conditions, and work with network management, analytics, and provider relations teams. Remote work is primary with occasional travel.