Remote Senior Analyst, Dental PPO Network Optimization

CVS Health; Butlerville (IN); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health is seeking a Senior Analyst, PPO Network Discount Optimization to enhance PPO discount performance across the United States. You will analyze provider reimbursement arrangements, lead fee schedule negotiations, and balance network adequacy with member access.

The role emphasizes data analytics, market dynamics, and stakeholder collaboration, with mostly remote work and occasional travel. Applicants should have 3+ years in related roles and strong negotiation skills.

Qualifications

• Three years in provider network management, sales, provider relations, or a payer setting.
• Ability to translate data insights into actionable strategies.
• Experience with provider contracting and reimbursement methodologies.

Responsibilities

• Analyze provider reimbursement arrangements, claims data, and network performance for PPO discount improvements.
• Lead fee schedule negotiations and network optimization initiatives aligned with financial goals.
• Evaluate market conditions and provider factors to craft contracting strategies.
• Assess financial and operational impact of reimbursement changes and network adjustments.
• Collaborate across network management, contracting, analytics, provider relations, and product teams.
• Build relationships with dental providers to facilitate successful negotiations.
• Present data-driven recommendations and business cases to leadership.

Skills

Analytical thinking

Data interpretation

Negotiation

Relationship building

Presentations

Communication

Education

Associate's degree

Job description

CVS Health is seeking a Senior Analyst, PPO Network Discount Optimization to enhance PPO discount performance across the United States. You will analyze provider reimbursement arrangements, lead fee schedule negotiations, and balance network adequacy with member access.

The role emphasizes data analytics, market dynamics, and stakeholder collaboration, with mostly remote work and occasional travel. Applicants should have 3+ years in related roles and strong negotiation skills.