Associate Director, RCM Payor Relations

Sun Life•Nashville, TN

1d•$101,000 - $151,500•Hybrid

About The Position

The Associate Director of Payor Relations is a senior leadership role within the Revenue Cycle Management (RCM) organization, responsible for overseeing all payor relations, contracting, credentialing, and fee negotiation functions across the enterprise. This role leads the Payor Relations and Credentialing teams, ensuring strong payor partnerships, compliant provider onboarding and offboarding, and alignment with operational and clinical priorities. This position works closely with RCM leadership, Operations, Clinical teams, and external payors to support growth, mitigate revenue risk, and ensure timely reimbursement through effective contract management, credentialing execution, and relationship oversight. The Associate Director may also be assigned special projects and initiatives in support of organizational and departmental priorities.

Requirements

10+ years of progressive experience in payor relations, contracting, credentialing, and fee negotiations
Hands-on experience working with PPO, Medicaid, and capitation-based reimbursement models
5+ years of experience managing multi-state Medicaid plans
Required experience working within large Dental Service Organizations (DSOs) or large multi-practice dental enterprises
Proven experience negotiating payor contracts and fee schedules
Demonstrated ability to lead and develop credentialing and payor relations teams
History working in credentialing software platforms such as Medallion and/or CredentialStream
Experience implementing and managing credentialing software solutions
Strong understanding of Revenue Cycle Management operations and workflows
Experience working closely with Operations and Clinical teams in provider onboarding and offboarding
Excellent written and verbal communication skills
Strong organizational, problem-solving, and decision-making abilities

Nice To Haves

Dental credentialing and payor relations experience strongly preferred; medical credentialing experience will be considered
Experience supporting growth, acquisitions, or large-scale onboarding initiatives

Responsibilities

Lead enterprise-wide payor relations strategy, including contract negotiations, fee schedule negotiations, renewals, amendments, and dispute resolution
Negotiate reimbursement rates and fee schedules for PPO, Medicaid, and capitation plans to support organizational financial goals
Build and maintain strong working relationships with commercial and government payors
Serve as the primary escalation point for complex payor issues impacting reimbursement, access, or compliance
Partner with RCM leadership to assess financial and operational impact of payor contracts and policy changes
Collaborate with Operations and Clinical leadership to support expansion, onboarding, and market entry initiatives
Oversee provider credentialing and enrollment processes across all markets and payors
Lead implementation, optimization, and ongoing management of credentialing software platforms
Update TIN’s with Payors as a practice is onboarded/acquired
Maintain licensing records of providers
Manage expiring credentials with payors
Manage payor portal users, access controls, and permissions to ensure security, compliance, and operational efficiency
Ensure timely onboarding and offboarding of providers in alignment with operational and clinical timelines
Establish standardized workflows, SLAs, and tracking mechanisms to reduce credentialing-related revenue delays
Ensure compliance with regulatory, payor, and accreditation requirements
Lead, mentor, and develop a team of credentialing and payor relations specialists
Set clear performance expectations, goals, and accountability metrics
Foster a collaborative, high-performing team culture aligned with RCM objectives
Partner with RCM leadership on workforce planning, training, and scalability initiatives
Work closely with RCM operations, billing, AR, and reporting teams to resolve payor-related issues
Collaborate with Operations and Clinical teams to support provider lifecycle management
Participate in cross-functional planning related to growth, acquisitions, and organizational changes
Provide clear communication and updates to leadership regarding payor risks, trends, and opportunities
Lead or support special projects and strategic initiatives as assigned by RCM leadership
Adapt to evolving business needs and assume additional responsibilities as required to support departmental and organizational objectives
Perform other duties as assigned to support business needs
Monitor key performance indicators related to credentialing timelines, payor responsiveness, fee performance, and revenue impact
Identify process gaps and implement improvements to enhance efficiency and reduce risk
Support audits, payor inquiries, and internal reviews as needed