Senior Dental PPO Network Optimization Analyst

CVS Health; Virginia Beach (VA); Remote; USD 47.000 - 122.000; Vollzeit

Benefits dieser Stelle

Bonus eligibility

Comprehensive benefits package

Zusammenfassung

CVS Health is seeking a Senior Analyst, PPO Network Discount Optimization to enhance the value of Aetna Dental networks across the United States. You will analyze provider reimbursement, identify optimization opportunities, and drive fee schedule renegotiations and network rebalancing to improve discount outcomes while maintaining network adequacy and member access.

The role is primarily remote, with occasional travel, and requires strong analytical capabilities, strategic thinking, and

Qualifikationen

• Minimum of 3 years in provider network management, sales, provider relations, customer service, healthcare reimbursement, dental practice operations, or payer environment.
• Strong analytical and problem-solving skills; translate data into actionable strategies.
• Proven negotiation, influencing and relationship-building capabilities.
• Excellent verbal, written, and presentation communication skills.

Aufgaben

• 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.
• Evaluate market conditions and provider factors to develop contracting strategies.
• Assess financial/operational impact of proposed reimbursement changes and network adjustments.
• Collaborate with network management, contracting, analytics, provider relations, and product teams.
• Build relationships with dental providers to facilitate negotiations.
• Present data-driven recommendations to leadership and stakeholders.

Kenntnisse

Analytical skills

Negotiation

Relationship building

Data analysis

Communication

Ausbildung

Associate degree or equivalent

Tools

Data visualization tools

Claims data analysis software

Jobbeschreibung

CVS Health is seeking a Senior Analyst, PPO Network Discount Optimization to enhance the value of Aetna Dental networks across the United States. You will analyze provider reimbursement, identify optimization opportunities, and drive fee schedule renegotiations and network rebalancing to improve discount outcomes while maintaining network adequacy and member access.

The role is primarily remote, with occasional travel, and requires strong analytical capabilities, strategic thinking, and