Director of Contracting & Payor Relations

The Director of Contracting & Payor Relations will lead enterprise-wide payor strategy for a growing, multi-location dental healthcare organization.

• Develop and manage enterprise-wide payor strategies covering commercial dental PPO plans, leased and umbrella networks, medical plans for oral surgery, and government programs.
• Lead fee schedule negotiations and renegotiations with national and regional carriers, including specialty-specific reimbursement schedules.
• Evaluate direct contracting versus leased network participation and recommend out-of-network or contract termination decisions using revenue projections and patient retention modeling.
• Create and maintain payor performance scorecards tracking patient volume, net collection rates, write-offs, and reimbursement for key procedure codes.
• Model the financial impact of proposed contracts and provide rate assumptions for budgeting, forecasting, and board reporting.
• Coordinate provider credentialing and payor enrollment to ensure dentists are in network before seeing their first patients.
• Serve as the senior escalation point for systemic claim denials, underpayments, reimbursement downgrades, and payor recoupment demands.
• Assess payor agreements during acquisition due diligence and lead contract integration following acquisitions.
• Collaborate with Revenue Cycle, Operations, Clinical Leadership, and Compliance teams to improve payment accuracy, educate front-office teams, and communicate payor policy changes.
• Monitor state insurance regulations and assess their implications for contractual arrangements across operating markets.

• Bachelor's degree in Business, Finance, Healthcare Administration, or a related field; an MBA or MHA is an advantage.
• At least 8 years of experience in payor contracting, network management, or managed care, including a minimum of 3 years leading negotiations.
• Hands-on experience negotiating dental PPO fee schedules for a multi-location organization or working on the payor or network side.
• Working knowledge of CDT coding, dental benefit design, leased networks, and claims adjudication.
• Strong Excel-based financial modeling skills and a demonstrated track record of securing and documenting reimbursement rate improvements.
• Experience with provider credentialing and enrollment processes, including CAQH.
• Previous experience in a dental support organization (DSO), multi-site healthcare environment, or private equity-backed organization is preferred.
• Experience with acquisition integration, medical billing for oral surgery, or Medicaid dental programs is a plus.
• Strong analytical and communication skills, with a data-driven approach and the confidence to present recommendations to CFOs, executive leadership, and board members.

• Competitive base salary with an annual performance-based bonus opportunity.
• Medical, dental, and vision insurance.
• 401(k) retirement plan with employer matching.
• Disability insurance and life insurance.
• Employee assistance program.
• Employee discounts.
• Flexible spending account and health savings account options.
• Paid time off.
• Direct collaboration with the CFO and executive leadership team.
• Opportunity to build and shape a strategic business function with a measurable impact on financial performance.
• Remote work arrangement.