Director of Payor Relations & Network Strategy (Remote)

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

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.