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Sr Analyst Network Relations

CVS Health

CVS Health is a health care innovation company. Together, we are are helping people on their path to better health.

Job Description
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.

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

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
Dental Relationships. Insurance background is preferred.

Education
BS and/or 5 years of dental experience

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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Sr Analyst Network Relations

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CVS Health

CVS Health is a health care innovation company. Together, we are are helping people on their path to better health.

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