Senior Analyst, Dental PPO Network Optimization

CVS Health; Lexington (KY); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental, leveraging claims data and market insights to renegotiate fee schedules and rebalance networks. The role emphasizes strategic contracting, provider engagement, and data-driven decision making.

Remote work is primary with occasional travel. Candidates should bring deep experience in dental networks, reimbursement methods, and analytics to drive improvements across nationwide provider networks.

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

PPO Network

Contract Negotiation

Data Analysis

Financial Acumen

Job description

CVS Health is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental, leveraging claims data and market insights to renegotiate fee schedules and rebalance networks. The role emphasizes strategic contracting, provider engagement, and data-driven decision making.

Remote work is primary with occasional travel. Candidates should bring deep experience in dental networks, reimbursement methods, and analytics to drive improvements across nationwide provider networks.