Director of Contracting & Payor Relations

📋 Description

• Develop and manage enterprise-wide payor strategies covering commercial dental PPO plans, leased
• Lead fee schedule negotiations and renegotiations with national and regional carriers, including
• Evaluate direct contracting versus leased network participation and recommend out-of-network or
• Create and maintain payor performance scorecards tracking patient volume, net collection rates
• Model the financial impact of proposed contracts and provide rate assumptions for budgeting
• Coordinate provider credentialing and payor enrollment to ensure dentists are in network before

🎯 Requirements

• Bachelor's degree in Business, Finance, Healthcare Administration, or a related field; an MBA or
• At least 8 years of experience in payor contracting, network management, or managed care, including
• Hands-on experience negotiating dental PPO fee schedules for a multi-location organization or
• 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
• Experience with provider credentialing and enrollment processes, including CAQH.

🎁 Benefits

• 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.