Payer Relations Manager

Dentive; Provo (UT); À distance; USD 95 000 - 120 000; Plein temps

Avantages offerts par ce poste

Full Benefits Package

Résumé du poste

Dentive is seeking a Payer Relations Manager to oversee payer relationships, contract negotiations and reimbursement management for Dentive-affiliated dental practices. This remote role focuses on optimizing payer participation and reimbursement opportunities across the network.

You will negotiate contracts, analyze fee schedules, and collaborate with credentialing teams and the Central Business Office to drive improved financial performance and strategic payer guidance.

Qualifications

• Minimum of 5 years of direct experience negotiating dental payer contracts and reimbursement agreements.
• Strong understanding of dental revenue cycle management, reimbursement management, insurance participation, credentialing, and provider enrollment processes.
• Experience managing payer relationships and resolving complex contractual and reimbursement escalations.
• Strong understanding of dental practice operations and the financial impact of payer participation and reimbursement.
• Experience analyzing complex payer agreements, identifying contractual risks, and recommending strategies to improve financial performance.
• Advanced analytical skills with the ability to interpret payer data, fee schedules, and reimbursement trends.

Responsabilités

• Negotiate, review, and maintain dental payer contracts and reimbursement terms on behalf of Dentive-affiliated dental offices.
• Develop and execute strategies to optimize payer participation, network offerings, and reimbursement opportunities.
• Manage and oversee reimbursement strategies, including analyzing fee schedules, reimbursement rates, and payer performance.
• Serve as the primary relationship contact for assigned national dental payers, managing escalations and resolving high-impact contractual issues.
• Build and maintain relationships with national and regional dental insurance carriers.
• Evaluate existing payer agreements to identify opportunities for improved reimbursement, contract optimization, and risk mitigation.
• Analyze payer contracts, reimbursement methodologies, fee schedules, and contract language to identify opportunities.
• Provide strategic payer guidance and recommendations to affiliated practices, credentialing teams, and the Central Business Office.
• Partner with credentialing teams to support payer participation, provider enrollment, and network access.
• Oversee team priorities and help establish processes and accountability to ensure departmental goals and service expectations are met.
• Collaborate with operations, finance, revenue cycle management, and other internal stakeholders to address payer-related challenges.
• Monitor payer trends, policy changes, network updates, and industry developments that may impact affiliated practices.
• Develop and monitor reporting and performance metrics to evaluate payer performance, reimbursement trends, team productivity, and contract effectiveness.
• Identify opportunities to standardize payer strategies and improve processes across the Dentive network.

Connaissances

Negotiation

Payer Contracts

Revenue Cycle Management

Credentialing

Provider Enrollment

Data Analysis

Description du poste

• Pay or shift range: $95,000 USD to $120,000 USD
  The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.
• Corporate
• Full-Time
• Requisition #: PAYER001985

Description

Payer Relations Manager - Remote Position
Dentive | Salary: $95,000–$120,000 per year
Full Benefits Package

We are looking for a Payer Relations Manager to join the Dentive team and oversee payer relationships, contract negotiations and reimbursement management. This individual will play a key role in optimizing payer participation and reimbursement opportunities across Dentive-affiliated dental practices.

Responsibilities

• Negotiate, review, and maintain dental payer contracts and reimbursement terms on behalf of Dentive-affiliated dental offices.
• Develop and execute strategies to optimize payer participation, network offerings, and reimbursement opportunities.
• Manage and oversee reimbursement strategies, including analyzing fee schedules, reimbursement rates, and payer performance to identify opportunities for improvement.
• Serve as the primary relationship contact for assigned national dental payers, managing escalations and resolving high-impact contractual and operational issues.
• Build and maintain strong relationships with national and regional dental insurance carriers.
• Evaluate existing payer agreements to identify opportunities for improved reimbursement, contract optimization, and risk mitigation.
• Analyze payer contracts, reimbursement methodologies, fee schedules, and contract language to identify financial and operational opportunities.
• Provide strategic payer guidance and recommendations to affiliated practices, credentialing teams, and the Central Business Office.
• Partner with credentialing teams to support payer participation, provider enrollment, and network access.
• Oversee team priorities and help establish processes and accountability to ensure departmental goals and service expectations are met.
• Collaborate with operations, finance, revenue cycle management, and other internal stakeholders to address payer-related challenges.
• Monitor payer trends, policy changes, network updates, and industry developments that may impact affiliated practices.
• Develop and monitor reporting and performance metrics to evaluate payer performance, reimbursement trends, team productivity, and contract effectiveness.
• Identify opportunities to standardize payer strategies and improve processes across the Dentive network.

Qualifications

• Minimum of 5 years of direct experience negotiating dental payer contracts and reimbursement agreements.
• Strong understanding of dental revenue cycle management, reimbursement management, insurance participation, credentialing, and provider enrollment processes.
• Experience managing payer relationships and resolving complex contractual and reimbursement escalations.
• Strong understanding of dental practice operations and the financial impact of payer participation and reimbursement.
• Experience analyzing complex payer agreements, identifying contractual risks, and recommending strategies to improve financial performance.
• Advanced analytical skills with the ability to interpret payer data, fee schedules, and reimbursement trends.

Equal Opportunity Employer

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