Payor Optimization Manager

SGA Dental Partners•Claxton, GA

2d•Onsite

About The Position

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.

Requirements

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.
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.
Strong understanding of insurance payor processes, credentialing standards, and provider data management.

Nice To Haves

5+ years of leadership or supervisory experience preferred.

Responsibilities

Leading, supervising, training, and developing credentialing and insurance contract support teams to ensure accuracy, efficiency, and performance.
Managing the full payer contracting lifecycle, including provider onboarding, applications, renewals, and contract execution support.
Maintaining strong relationships with payer partners to support contract negotiations, reimbursement optimization, and long-term collaboration.
Negotiating contracts to secure favorable terms, reimbursement rates, and conditions for dental services.
Overseeing contracting and credentialing workflows, including pending contracts, re-credentialing, new locations, missing documentation, and payer updates.
Conducting market and payer landscape analysis to identify trends, risks, and opportunities impacting strategy and reimbursement.
Developing and executing payer strategies aligned with organizational goals to improve financial performance and operational efficiency.
Utilizing data analytics and reporting to evaluate contract performance and identify areas for improvement.
Ensuring compliance with all applicable healthcare regulations, payer requirements, and internal policies.
Collaborating cross-functionally with finance, operations, clinical, and revenue cycle teams to align payer strategies and improve workflows.
Communicating effectively with offices and stakeholders during contract changes, renewals, and payer updates.
Identifying and supporting process improvement and workflow optimization initiatives.
Maintaining strict adherence to regulatory and documentation standards across all payer and credentialing activities.
Performing additional administrative or operational duties as assigned.