Director of Contracting & Payor Relations

Riccobene Associates Family Dentistry•Cary, NC

1d•Remote

About The Position

We are a growing, private equity backed dental support organization with dozens of practice locations across multiple states in the Southeast and Mid-Atlantic. The group supports general dentistry and a full range of specialties, including oral surgery, endodontics, periodontics, pediatrics, and orthodontics, and continues to grow through acquisitions and new offices. This is a confidential search. The company name will be shared with qualified candidates after an initial conversation. The Director of Payor Relations owns payor strategy for the entire organization. You will decide with the CFO and Clinical Leadership which networks we participate in, negotiate the fee schedules that drive revenue, and manage relationships with every major dental carrier we work with. You will report directly to the CFO and have real authority over a contract portfolio that spans many locations, providers, and tax IDs. The work is visible to the executive team and the board, and the results show up directly in net revenue. This role suits someone who likes to build: you will create the payor scorecard, set the negotiation calendar, and write the playbook for integrating acquired practices.

Requirements

Bachelor's degree in business, finance, healthcare administration, or a related field; MBA or MHA a plus.
8 or more years in payor contracting, network management, or managed care, including at least 3 years leading negotiations.
Hands-on experience negotiating dental PPO fee schedules for a multi-location group, or from the payor or network side.
Working knowledge of CDT coding, dental benefit design, leased networks, and claim adjudication.
Strong Excel-based financial modeling, with a record of documented rate improvements.
Experience with provider credentialing and enrollment, including CAQH.
A direct, data-first communication style and the confidence to present recommendations to a CFO and board.

Nice To Haves

DSO, multi-site healthcare, or private equity backed experience preferred.
Experience with acquisition integration, oral surgery medical billing, or Medicaid dental programs is a plus.

Responsibilities

Set and run the enterprise payor strategy for the DSO across commercial dental PPO plans, leased and umbrella networks, medical plans for oral surgery, and government programs.
Lead fee schedule negotiations and renegotiations with national and regional carriers, including separate specialty schedules.
Decide between direct contracts and leased network access for each payor, and recommend out-of-network or termination moves backed by revenue and patient retention modeling.
Build and maintain a payor scorecard covering volume, net collection rate, write-offs, and reimbursement on top procedure codes.
Model the financial impact of every proposed contract and supply rate assumptions for budgets and board reporting.
Coordinate with provider credentialing and payor enrollment so dentists are in network by their first patient day.
Act as the senior escalation point with payors for systemic denials, underpayments, downgrades, and recoupment demands.
Assess payor contracts in acquisition diligence and lead contract integration after close.
Partner with Revenue Cycle, Operations, Clinical leadership, and Compliance on payment accuracy, front office education, and payor policy changes.
Monitor state insurance regulations that affect payor contracts in the states where we operate.