Remote Senior Analyst, Dental PPO Network Strategy

CVS Health

Central City (CO)

Remote

USD 47,000 - 122,000

Full time

5 days ago
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Benefits offered by this job

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings
Wellness programs

Job summary

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental nationwide. The role analyzes provider reimbursement, leads fee schedule negotiations, and guides network rebalancing while considering market dynamics and provider economics.

The position requires strong analytical skills, negotiations and relationship-building, with remote work flexibility and travel as needed. 3+ years in relevant roles and 5+ years in the dental industry are preferred.

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.
  • Knowledge of provider contracting, fee schedule development, and healthcare reimbursement methodologies.
  • One to three years of financial analysis, healthcare economics, or related analytical experience.
  • Experience utilizing data visualization and reporting tools to support business decision-making.

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

Provider network management
Data analysis
Negotiation
Relationship management
Healthcare reimbursement

Tools

Claims data tools

Job description

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental nationwide. The role analyzes provider reimbursement, leads fee schedule negotiations, and guides network rebalancing while considering market dynamics and provider economics.

The position requires strong analytical skills, negotiations and relationship-building, with remote work flexibility and travel as needed. 3+ years in relevant roles and 5+ years in the dental industry are preferred.

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