Director of Contracting & Payor Relations

Riccobene Associates Family Dentistry; Cary (NC); Hybrid; USD 150,000 - 230,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

401(k) with match

Paid time off

Remote work option

Job summary

Riccobene Associates Family Dentistry seeks a Director of Payor Relations to lead payor strategy for the enterprise. You will partner with the CFO and clinical leadership to select networks, negotiate fee schedules, and manage relationships with major dental carriers.

You will own a multi-location contract portfolio with authority over the playbook and calendar, reporting to the CFO with visibility to the board on net revenue impact.

Qualifications

• Bachelor's degree in business, finance, healthcare administration, or related field.
• 8+ years in payor contracting, network management, or managed care with at least 3 years leading negotiations.
• Experience negotiating dental PPO fee schedules for multi-location groups.
• Working knowledge of CDT coding, dental benefit design, leased networks, and claim adjudication.
• Strong Excel-based financial modeling with documented rate improvements.
• Experience with provider credentialing and enrollment, including CAQH.
• DSO or multi-site healthcare experience preferred; private equity backing a plus.
• A data-first communication style with the CFO and board.

Responsibilities

• Set enterprise payor strategy for the DSO across PPO plans and government programs.
• Lead fee schedule negotiations and renegotiations with national and regional carriers.
• Decide direct contracts vs leased network access and guidance on out-of-network moves.
• Build and maintain a payor scorecard including volume, collection rate, and write-offs.
• Model financial impact of contracts and supply rate assumptions for budgets.
• Coordinate credentialing and enrollment so networks are active by first day.
• Escalate payor denials and recoupment issues with payors as senior point of contact.
• Assess payor contracts in acquisition due diligence and post-close integration.
• Partner with Revenue Cycle, Operations, Clinical leadership, and Compliance on policy changes.
• Monitor state insurance regulations affecting payor contracts.

Skills

Payor contracting

Network management

Financial modeling

Data-driven communication

Negotiation

Relationship management

CAQH knowledge

Excel

Education

Bachelor's degree in business/finance/healthcare administration

MBA or MHA (plus)

Tools

Excel

CAQH

Job description

About the company

We are a growing, private equity backed dental support organization with dozens of practice locations across multiple states in the Southeast and Mid-Atlantic. The group supports general dentistry and a full range of specialties, including oral surgery, endodontics, periodontics, pediatrics, and orthodontics, and continues to grow through acquisitions and new offices.

This is a confidential search. The company name will be shared with qualified candidates after an initial conversation.

• Reports to: Chief Financial Officer
• Location: Southeast U.S,. hybrid
• Travel: Up to 20%
• Employment type: Full time, exempt

The opportunity

The Director of Payor Relations owns payor strategy for the entire organization. You will decide with the CFO and Clinical Leadership which networks we participate in, negotiate the fee schedules that drive revenue, and manage relationships with every major dental carrier we work with.

You will report directly to the CFO and have real authority over a contract portfolio that spans many locations, providers, and tax IDs. The work is visible to the executive team and the board, and the results show up directly in net revenue.

This role suits someone who likes to build: you will create the payor scorecard, set the negotiation calendar, and write the playbook for integrating acquired practices.

What you will do

• Set and run the enterprise payor strategy for the DSO across 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 separate specialty schedules.
• Decide between direct contracts and leased network access for each payor, and recommend out-of-network or termination moves backed by revenue and patient retention modeling.
• Build and maintain a payor scorecard covering volume, net collection rate, write-offs, and reimbursement on top procedure codes.
• Model the financial impact of every proposed contract and supply rate assumptions for budgets and board reporting.
• Coordinate with provider credentialing and payor enrollment so dentists are in network by their first patient day.
• Act as the senior escalation point with payors for systemic denials, underpayments, downgrades, and recoupment demands.
• Assess payor contracts in acquisition diligence and lead contract integration after close.
• Partner with Revenue Cycle, Operations, Clinical leadership, and Compliance on payment accuracy, front office education, and payor policy changes.
• Monitor state insurance regulations that affect payor contracts in the states where we operate.

What you bring

• Bachelor's degree in business, finance, healthcare administration, or a related field; MBA or MHA a plus.
• 8 or more years in payor contracting, network management, or managed care, including at least 3 years leading negotiations.
• Hands-on experience negotiating dental PPO fee schedules for a multi-location group, or from the payor or network side.
• Working knowledge of CDT coding, dental benefit design, leased networks, and claim adjudication.
• Strong Excel-based financial modeling, with a record of documented rate improvements.
• Experience with provider credentialing and enrollment, including CAQH.
• DSO, multi-site healthcare, or private equity backed experience preferred.
• Experience with acquisition integration, oral surgery medical billing, or Medicaid dental programs is a plus.
• A direct, data-first communication style and the confidence to present recommendations to a CFO and board.

What we offer

• Competitive base salary with annual bonus opportunity tied to results.
• Medical, dental, vision, and 401(k) benefits, plus paid time off.
• A seat at the table with the CFO and executive team.
• The chance to build a function and see its impact on a growing organization.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

We are an equal opportunity employer.

Work Location: Remote