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Senior Analyst – Network Relations
| Company | CVS Health |
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| Location | Texas, USA |
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| Salary | $46988 – $102000 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Senior |
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Requirements
- 5 years of Experience in a Dental Office and/or payor setting, Sales or Service.
- Strong verbal and written communication skills.
Responsibilities
- Act as a primary resource for all dental products (DHMO, PPO, Medicare) for providers, sales and marketing, and Dental Service Centers.
- 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.
- Negotiate 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.
Preferred Qualifications
- Experience in the dental field and knowledge of PPO, DMO, and Medicare networks.
