Analyst, PPO Network Discount Optimization

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 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., * 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., Firewall Operations Multicasting Cisco Routers Voice Over IP Network Routing Network Switches CompTIA Network+

Writing Medicare Geography Economics Dentistry Operations Leadership Compassion Negotiation Communication Data Analysis Presentations Prioritization Problem Solving Reporting Tools Market Dynamics Customer Service Business Results Financial Analysis Influencing Skills Advanced Analytics Strategic Thinking Data Visualization Network Management Time Off Management Relationship Building Relationship Management Provider Network Management Network Performance Management, 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., * 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.

Education

• Associate’s degree or equivalent combination of education and experience.

Key Competencies

• Strategic Thinking
• Data Analysis & Interpretation
• Contract Negotiation
• Financial Acumen
• Relationship Management
• Influencing & Persuasion
• Communication & Presentation Skills
• Process Improvement
• Business Impact Assessment, Full Stack Development Business Transformation Building Management System Network Planning And Design Multicast Routing Protocols Troubleshooting (Problem Solving) Cisco Certified Network Associate Supervisory Control And Data Acquisition (SCADA) +0 Network Strategy Analyst CVS Health

Remote

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This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

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.

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., This position offers the opportunity to directly influence network performance, provider engagement, and overall business results while supporting the continued growth and competitiveness of Aetna Dental’s national provider network.