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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
5 years of Experience in a Dental Office and/or payor setting, Sales or Service.
Strong verbal and written communication skillsPreferred Qualifications
Experience in the dental field and knowledge of PPO, DMO, and Medicare networks
Education
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$46,988.00 - $102,000.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 07/15/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.