Senior Dental PPO Network Optimization Analyst

CVS Health; Idaho Falls (ID); Remote; USD 47,000 - 122,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits package

Job summary

CVS Health, in partnership with Aetna Dental, is seeking a Senior Analyst to optimize PPO discount performance across the United States. You will analyze provider reimbursement, lead fee schedule negotiations, and drive network rebalancing while ensuring access and network adequacy.

The role is primarily remote with occasional travel, requires 5+ years in dental network management and strong data analysis, negotiation, and stakeholder collaboration skills.

Qualifications

• Minimum 3 years of experience in provider network management, sales, provider relations, customer service, healthcare reimbursement, dental practice operations, or a payer environment.
• Proven ability to analyze data and translate findings into actionable strategies.
• Strong negotiation, influencing, and relationship-building capabilities.
• Experience with claims or reimbursement data.

Responsibilities

• Analyze provider reimbursement, claims data, and network metrics to spot PPO discount opportunities.
• Lead fee schedule negotiations and network optimization to meet financial goals.
• Assess market conditions and provider factors to craft targeted contracts.
• Evaluate financial and operational impact of proposed reimbursement changes.
• Collaborate with network management, contracting, analytics, provider relations and product teams.
• Build and maintain relationships with dental providers to enable negotiations.
• Present data-driven recommendations and business cases to leadership.

Skills

Data analysis

Negotiation

Provider relations

Financial acumen

Tools

Data visualization tools

Job description

CVS Health, in partnership with Aetna Dental, is seeking a Senior Analyst to optimize PPO discount performance across the United States. You will analyze provider reimbursement, lead fee schedule negotiations, and drive network rebalancing while ensuring access and network adequacy.

The role is primarily remote with occasional travel, requires 5+ years in dental network management and strong data analysis, negotiation, and stakeholder collaboration skills.