Senior Analyst, Dental PPO Network Optimization

CVS Health; Williamstown (NJ); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Analyst for PPO Network Discount Optimization to enhance Aetna Dental’s provider network value nationwide. You’ll analyze reimbursement arrangements, identify optimization opportunities, and drive fee schedule renegotiations and network rebalancing initiatives.

The role emphasizes strong analytical capabilities, market awareness of dental products (PPO/Medicare), and strategic relationship management to influence provider participation while meeting financial and

Qualifications

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

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

Data analysis

Negotiation

Relationship building

Data visualization

Tools

Data visualization tools

Job description

CVS Health is seeking a Senior Analyst for PPO Network Discount Optimization to enhance Aetna Dental’s provider network value nationwide. You’ll analyze reimbursement arrangements, identify optimization opportunities, and drive fee schedule renegotiations and network rebalancing initiatives.

The role emphasizes strong analytical capabilities, market awareness of dental products (PPO/Medicare), and strategic relationship management to influence provider participation while meeting financial and