Dental Network Relations Senior Analyst

CVS Health•Washington, NV

3d•$46,988 - $122,400•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Senior Analyst, PPO Network Discount Optimization plays a critical role in enhancing the value and competitiveness of Aetna Dental's provider networks by driving improvements in PPO discount performance across the United States. This position is responsible for analyzing provider reimbursement arrangements, identifying optimization opportunities, and executing provider fee schedule renegotiations and network rebalancing strategies. The ideal candidate possesses a strong understanding of dental insurance products, including PPO and Medicare plans, along with knowledge of market dynamics, provider economics, and competitive network strategies. This role requires advanced analytical capabilities, strategic thinking, and strong relationship management skills to influence provider participation and achieve financial and operational objectives. The Senior Analyst leverages claims, reimbursement, and market data to assess network performance, quantify business impacts, and develop recommendations that improve discount outcomes while maintaining provider network adequacy and member access. While the role is primarily remote and conducted through virtual and telephonic engagement, occasional travel may be required.

Requirements

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.

Nice To Haves

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.