[Hiring] Dental Network Relations, Senior Analyst @CVS Health

Role Description

Act as a primary resource for all dental products (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 nationally retaining providers within the PPO network.
• Manage termination and sale of practice requests and ensure compliance with termination obligations and cost of care improvements.
• Maintain and strengthen provider relationships to ensure network stability.
• Negotiate contract language and provider compensation.
• Timely response to correspondence from Provider offices, including but not limited to:
  • Termination requests
  • Tax ID changes
  • Hold requests
  • Claim reimbursement
  • System and directory accuracy
  • Various contractual issues
• Document resolution and follow through communicated to all parties.
• Presentation of PPO plan design, compensation process, claim submission, and referral policies during new office orientations and reorientations via telephone.
• Knowledge of the competitive market and Aetna's relevant competitive position.
• Presentation of Aetna's electronic capabilities for dental providers to achieve Company goals and targets, promoting all EDI initiatives.

Qualifications

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

Requirements

• Experience in the dental field and knowledge of PPO and Medicare networks.
• Bachelor's degree or relevant experience.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.