Payor Optimization Manager

SGA Dental Partners; Claxton (GA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

401(k) Retirement Plan

Health and Vision Insurance

Employer-Paid Dental Insurance

Life Insurance

Care.com Membership

Employee Assistance Program

Disability Insurance

Critical Illness Coverage

Accident Coverage

Career Growth Opportunities

Job summary

SGA Dental Partners is seeking a Payor Optimization Manager to lead payor contracting, credentialing, and insurance support across our dental practices. You will oversee onboarding, applications, renewals, contract execution, and maintain compliant documentation for all providers and locations.

You will build and execute payer strategies, analyze contract performance, and collaborate with finance, operations, clinical, and revenue cycle teams to improve reimbursement and efficiency.

Qualifications

• Bachelor’s degree or equivalent experience in a relevant field.
• 8+ years in payor contracting, credentialing, or revenue cycle management in healthcare.
• 5+ years of leadership or supervisory experience preferred.
• Strong understanding of payer processes and credentialing standards.

Responsibilities

• Lead credentialing and insurance contract support teams to ensure accuracy and performance.
• Oversee provider onboarding, applications, renewals, and contract execution.
• Develop payer strategies and negotiate favorable terms with payers.
• Monitor workflows for contracting and credentialing, including re-credentialing and new locations.
• Collaborate with finance, operations, clinical, and revenue cycle teams.
• Ensure compliance with regulations and internal policies.

Skills

Payer contracting

Credentialing leadership

Data analytics

MS Office proficiency

Cross-functional collaboration

Communication skills

Education

Bachelor's degree in Business Administration, Healthcare Management, or related field

Tools

Credentialing software

Job description

SGA Dental Partners is hiring for a Payor Optimization ManagerThe Payor Optimization Manager is responsible for leading and overseeing the payor contracting, credentialing, and insurance support functions within the organization. This role ensures efficient execution of all provider onboarding, payor applications, and renewals, while maintaining accurate and compliant documentation across all providers and entities. The ideal candidate is detail-oriented, proactive, and experienced in managing both people and processes in a fast-paced healthcare or dental service environment.Schedule: Mon - Fri 8 - 5Key Responsibilities:Support as needed leading, supervising, training, and developing credentialing and insurance contract support teams to ensure accuracy, efficiency, and performanceSupport the full payer contracting lifecycle, including provider onboarding, applications, renewals, and contract execution supportSupport and maintain strong relationships with payer partners to support contract negotiations, reimbursement optimization, and long-term collaborationSupport contract negotiations to secure favorable terms, reimbursement rates, and conditions for dental servicesSupport oversight of contracting and credentialing workflows, including pending contracts, re-credentialing, new locations, missing documentation, and payer updatesConduct market and payer landscape analysis to identify trends, risks, and opportunities impacting strategy and reimbursementDevelop and execute payer strategies aligned with organizational goals to improve financial performance and operational efficiencyUtilize data analytics and reporting to evaluate contract performance and identify areas for improvementEnsure compliance with all applicable healthcare regulations, payer requirements, and internal policiesCollaborate cross-functionally with finance, operations, clinical, and revenue cycle teams to align payer strategies and improve workflowsCommunicate effectively with offices and stakeholders during contract changes, renewals, and payer updatesIdentify and support process improvement and workflow optimization initiativesMaintain strict adherence to regulatory and documentation standards across all payer and credentialing activitiesPerform additional administrative or operational duties as assignedKnowledge/Skills/AbilitiesExcellent organizational and communication skills with strong attention to detail.Proficiency in Microsoft Office Suite and credentialing/contract management software systems.Experience in a Dental Service Organization (DSO) or multi-location healthcare setting.Familiarity with payer portals, CAQH, and state/federal credentialing requirements.Demonstrated ability to manage competing priorities and tight deadlines.Collaborative leadership style with a focus on mentorship and cross-team support.Education/ ExperienceBachelor’s degree in Business Administration, Healthcare Management, or related field (or equivalent experience).8+ years of experience in payor contracting, credentialing, or revenue cycle management within a dental or healthcare organization.5+ years of leadership or supervisory experience preferred.Strong understanding of insurance payor processes, credentialing standards, and provider data management.Benefits We Offer:Paid Holidays and Paid Time Off (PTO)401(k) Retirement Plan Health and Vision InsuranceEmployer-Paid Dental Insurance, Life Insurance, Care.com Membership & Employee Assistance ProgramSupplemental Coverage (Disability, Critical Illness, Accident)Career Growth and Development OpportunitiesIn hometown communities, SGA Dental Partners is a beacon of positive energy, delivering the highest level of clinical excellence and patient-centered care. Apply today to join us in making a difference!In order to maintain a high level of clinical excellence, SGA Dental Partners and dental practices affiliated with SGA maintain a drug free and alcohol free workplace. All new hires are required to pass a full panel drug screening as a condition of employment.SGA Dental Partners is an Equal Opportunity Employer and values diversity at every level of our team. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.