Senior Dental PPO Network Optimization Analyst

Sky Pediatric Dentistry; Tennessee; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health, including Aetna Dental, seeks a Senior Analyst to optimize PPO discounts across the national network. You will analyze reimbursement structures, lead fee schedule negotiations, and balance network performance with member access.

The role combines data-driven strategy with stakeholder collaboration and occasional travel. The position emphasizes analytical excellence, industry knowledge in dental networks, and strong negotiation and communication skills to influence provider

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.
• 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

Provider network management

Analytical skills

Negotiation

Communication skills

Data analysis

Education

Associate's degree or equivalent

Job description

CVS Health, including Aetna Dental, seeks a Senior Analyst to optimize PPO discounts across the national network. You will analyze reimbursement structures, lead fee schedule negotiations, and balance network performance with member access.

The role combines data-driven strategy with stakeholder collaboration and occasional travel. The position emphasizes analytical excellence, industry knowledge in dental networks, and strong negotiation and communication skills to influence provider