Senior Analyst, Network Relations

CVS Health • Washington, DC

2d

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 Act as a primary resource for all dental products (DHMO, PPO, Medicare) for providers, sales and marketing, and Dental Service Centers to aid in the achievement of Aetna Key Performance Measures. Act as the liaison with the Primary Care Dentists and Specialists in a specific geographic territory responsible for overall maintenance and territory management of the provider network, as a functional subject matter expert, demonstrating a strong understanding of Aetna's Dental Products and market position. Negotiation of contract language and provider compensation. Review quality and service reports with provider and appropriate staff, contacting Dental providers regarding quality reviews conducted where unacceptable results were obtained. Timely response to correspondence from Provider offices, included, but not limited to termination requests, tax id changes, hold requests, claim reimbursement, system, directory accuracy and various contractual issues. Documented resolution and follow through communicated to all parties. Presentation of DHMO and PPO plan design, compensation process, claim / encounter submission, and referral policies during new office orientations and reorientations via the telephone Knowledge of the competitive market and Aetna's relevant competitive position, to include member appointment access Presentation of Aetna's electronic capabilities for dental providers to achieve Company goals and targets, promote all EDI initiatives.

Requirements

• 5 years of Experience such as Sales, Service, Dental Office and/or payor setting.
• Strong verbal and written communication skills.

Nice To Haves

• Experience in the dental field and knowledge of PPO, DMO, and Medicare networks.

Responsibilities

• Act as a primary resource for all dental products (DHMO, PPO, Medicare)
• Act as the liaison with the Primary Care Dentists and Specialists in a specific geographic territory
• Negotiation of contract language and provider compensation
• Review quality and service reports with provider and appropriate staff
• Timely response to correspondence from Provider offices
• Presentation of DHMO and PPO plan design, compensation process, claim / encounter submission, and referral policies during new office orientations and reorientations via the telephone
• Knowledge of the competitive market and Aetna's relevant competitive position, to include member appointment access
• Presentation of Aetna's electronic capabilities for dental providers to achieve Company goals and targets, promote all EDI initiatives.

Benefits

• This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
• The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level