Payor Optimization Manager

SGA Dental; Northern (KY); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Paid holidays

401(k) plan

Health insurance

Dental insurance

Vision insurance

Life insurance

Care.com membership

Employee Assistance Program

Career growth opportunities

Job summary

SGA Dental Partners is seeking a Payor Optimization Manager to lead payor contracting, credentialing, and insurance support across our multi-location dental organization.

The role requires 8+ years in payor contracting or revenue cycle within healthcare, with 5+ years of leadership experience. You will collaborate with finance, operations, clinical, and revenue cycle teams to optimize reimbursements and ensure regulatory compliance.

Qualifications

• Bachelor’s degree in Business Administration, Healthcare Management, or related field.
• 8+ years of experience in payor contracting, credentialing, or revenue cycle management within a dental or healthcare organization.
• Leadership or supervisory experience 5+ years preferred.

Responsibilities

• Lead credentialing and insurance contract support teams to ensure accuracy and performance.
• Oversee full payer contracting lifecycle: onboarding, applications, renewals, and contract execution support.
• Maintain strong relationships with payer partners to support negotiations and reimbursement optimization.
• Assist contract negotiations to secure favorable terms and rates for dental services.
• Ensure compliance with healthcare regulations, payer requirements, and internal policies.

Skills

Attention to detail

Organizational skills

Communication skills

MS Office proficiency

Credentialing software

Education

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

Tools

Credentialing software

Payer portal systems (CAQH)

Job description

SGA Dental Partners is hiring for a Payor Optimization Manager

The 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 - 5

Key Responsibilities

• Support as needed leading, supervising, training, and developing credentialing and insurance contract support teams to ensure accuracy, efficiency, and performance
• Support the full payer contracting lifecycle, including provider onboarding, applications, renewals, and contract execution support
• Support and maintain strong relationships with payer partners to support contract negotiations, reimbursement optimization, and long-term collaboration
• Support contract negotiations to secure favorable terms, reimbursement rates, and conditions for dental services
• Support oversight of contracting and credentialing workflows, including pending contracts, re-credentialing, new locations, missing documentation, and payer updates
• Conduct market and payer landscape analysis to identify trends, risks, and opportunities impacting strategy and reimbursement
• Develop and execute payer strategies aligned with organizational goals to improve financial performance and operational efficiency
• Utilize data analytics and reporting to evaluate contract performance and identify areas for improvement
• Ensure compliance with all applicable healthcare regulations, payer requirements, and internal policies
• Collaborate cross-functionally with finance, operations, clinical, and revenue cycle teams to align payer strategies and improve workflows
• Communicate effectively with offices and stakeholders during contract changes, renewals, and payer updates
• Identify and support process improvement and workflow optimization initiatives
• Maintain strict adherence to regulatory and documentation standards across all payer and credentialing activities
• Perform additional administrative or operational duties as assigned

Knowledge/Skills/Abilities

• Excellent 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 / Experience

Bachelor’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 Insurance
• Employer-Paid Dental Insurance, Life Insurance, Care.com Membership & Employee Assistance Program
• Supplemental Coverage (Disability, Critical Illness, Accident)
• Career Growth and Development Opportunities

In hometown communities, SGA Dental Partners is a beacon of positive energy, delivering the highest level of clinical excellence and patient-centered care.

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.

In hometown communities across the country, SGA Dental Partners is a beacon of positive energy, making a meaningful difference in the lives of patients, team members, and the communities we serve. Built through the coming together of long respected dental practices, we are united by a shared commitment to clinical excellence, compassionate care, and a people first culture. At SGA, we believe in continuous improvement because we know that when our people grow, our care gets better. Guided by our Empower Improvement mindset and our belief that we get better every day, we invest in our teams through development, collaboration, and leadership opportunities. Whether you are early in your career or an experienced professional, you will find an environment that supports growth, recognizes contribution, and encourages innovation.