Senior Dental Network Optimization Analyst

CVS Health; Guin (AL); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical benefits

Dental + Vision

Paid time off

Retirement plan

Wellness programs

Job summary

CVS Health is seeking a Senior Analyst to optimize PPO network discounts across the United States. You will analyze provider reimbursement, lead fee schedule negotiations, and evaluate market dynamics to improve discount outcomes while maintaining network adequacy and member access.

The role leverages claims data and market insights; responsibilities include collaborating with network management, contracting, analytics, and product teams. Remote with occasional travel is possible.

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

Data Analysis & Interpretation

Contract Negotiation

Financial Acumen

Process Improvement

Job description

CVS Health is seeking a Senior Analyst to optimize PPO network discounts across the United States. You will analyze provider reimbursement, lead fee schedule negotiations, and evaluate market dynamics to improve discount outcomes while maintaining network adequacy and member access.

The role leverages claims data and market insights; responsibilities include collaborating with network management, contracting, analytics, and product teams. Remote with occasional travel is possible.