Senior Dental PPO Network Optimization Analyst

CVS Health Corporation; New Jersey; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health Corporation is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the United States. The role focuses on analyzing provider reimbursement arrangements, negotiating fee schedules, and rebalancing networks to improve discount performance while preserving network adequacy.

The ideal candidate will have strong analytical capabilities, solid negotiation skills, and experience with claims or reimbursement data.

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.
• Excellent verbal, written, and presentation communication skills.
• Proficiency in data analysis and experience working with claims or reimbursement data.

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

Analytical skills

Negotiation

Relationship management

Communication

Data analysis

Education

Associate's degree or equivalent

Tools

Data visualization tools

Job description

CVS Health Corporation is seeking a Senior Analyst to optimize PPO network discounts for Aetna Dental across the United States. The role focuses on analyzing provider reimbursement arrangements, negotiating fee schedules, and rebalancing networks to improve discount performance while preserving network adequacy.

The ideal candidate will have strong analytical capabilities, solid negotiation skills, and experience with claims or reimbursement data.