Senior Analyst Dental PPO Network Optimization

CVS Health; South Dakota Park (SD); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Senior Analyst to optimize PPO network discounts across the United States, analyzing reimbursement arrangements and leading fee schedule renegotiations and network rebalancing.

The role requires deep dental insurance knowledge (PPO/Medicare), strong analytical skills, and proven negotiation and relationship-building abilities to influence provider participation while ensuring network adequacy and member access. Remote role with some travel.

Qualifications

• Minimum 3 years in provider network management, sales, provider relations, or payer environment.
• Strong analytical and problem-solving skills with data interpretation.
• Proven negotiation and relationship-building capabilities.
• Experience with claims or reimbursement data and data visualization/reporting tools.
• 5+ years in the dental industry, including PPO, DMO, Medicare familiarity.

Responsibilities

• Analyze provider reimbursement arrangements, claims data, and network performance metrics.
• Lead provider fee schedule negotiations and network optimization initiatives.
• Evaluate market conditions and contracting strategies.
• Assess financial and operational impact of reimbursement changes.
• Collaborate with network management, contracting, analytics, and provider relations.
• Build relationships with dental providers to facilitate negotiations.
• Present data-driven recommendations and business cases to leadership.

Skills

Analytical skills

Negotiation

Relationship-building

Data analysis

Data visualization

Tools

Data visualization tools

Reporting tools

Job description

CVS Health is seeking a Senior Analyst to optimize PPO network discounts across the United States, analyzing reimbursement arrangements and leading fee schedule renegotiations and network rebalancing.

The role requires deep dental insurance knowledge (PPO/Medicare), strong analytical skills, and proven negotiation and relationship-building abilities to influence provider participation while ensuring network adequacy and member access. Remote role with some travel.