Director, Payor Relations
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Job Location:
El Segundo, CA - USA
Monthly Salary:
$ 125000 - 150000
Posted on:
13 hours ago
Vacancies:
1 Vacancy
Department:
Job Summary
InterDent is a well-established and growing organization supporting 2100 employees and 170 dental offices across 8 western states under the brands including Gentle Dental SmileKeepers and Capitol Dental.
InterDent Service Corporation provides comprehensive dental support and administrative services to over 165 dental practices employing more than 400 dentists across eight states. These practices including the Gentle Dental and Blue Oak Dental brands offer high-quality patient-centered dental care. Additionally InterDent operates Capitol Dental Care (CDC) a capitated value-based care program in Oregon. CDC partners with coordinated care organizations to deliver dental services under the Oregon Health Plan focusing on preventive care and improving both oral and systemic health for children and low-income patients since 1994.
At InterDent our vision is to provide exceptional lifelong integrated oral healthcare services. We enhance the quality of our patients lives by supporting the provision of accessible oral healthcare which is paramount to overall health and wellbeing. We focus on a commitment to patient care operational and clinical excellence personal accountability building relationships and seeking out innovative and creative approaches to support our patients and teams.
Position Overview
The Director of Payor Relations is responsible for securing optimal compensation and contractual terms for supported dental offices across multiple states. This role combines strategic negotiation data-driven analysis and strong relationship management to maximize revenue performance while building sustainable mutually beneficial partnerships with payors. Acting as a subject matter expert on contracting and reimbursement the Director collaborates closely with senior leadership to shape payor strategy guide operational alignment and ensure compliance with regulatory and contractual standards.
Key Responsibilities
- Strategic Opportunity Analysis
- Own and refine the opportunity model that quantifies and prioritizes payor negotiation opportunities.
- Enhance model functionality and outputs to improve decision-making.
- Oversee and guide all opportunity assessment analytics ensuring accuracy and business impact.
- Payor Negotiations & Contracting
- Lead negotiations with payors across plan types (PPO HMO leased networks etc.) to achieve optimal fee schedules and contract terms.
- Develop negotiation packets and strategies that drive targeted payors into active discussions.
- Establish recurring negotiation cycles with key payors to maintain competitive reimbursement.
- Evaluate underperforming agreements; recommend continuation renegotiation or termination.
- Monitor existing contracts to ensure compliance minimize provider risk and maintain best-in-class terms.
- Payor Relationship Management
- Build and maintain strong collaborative relationships with payors.
- Conduct regular performance reviews to identify opportunities for enhanced reimbursement and operational efficiency.
- Serve as the escalation point for multi-practice payor issues coordinating cross-functional solutions.
- Provide expert guidance to internal teams (Operations Revenue Cycle Compliance) on payor protocols claims processing and reimbursement trends.
- Operational & Compliance Support
- Drive adoption of operational efficiencies (EDI EFT ERA web portals delegated credentialing) in alignment with industry best practices.
- Partner with Compliance to resolve patient grievances promptly and fairly.
- Maintain a comprehensive current library of payor agreements.
- Represent the organization and its brands in payor meetings clearly articulating market position and value proposition.
Ideal Candidate Profile
- Proven success in payor contracting and negotiations preferably within dental medical or multi-site healthcare organizations.
- Strong analytical and financial acumen with ability to translate complex data into actionable strategy.
- Exceptional relationship-building communication and influencing skills.
- Knowledge of reimbursement models compliance requirements and industry best practices.
Education & Experience
- Minimum of a bachelors degree in business Healthcare Administration or related field (preferred). Masters degrees are favorable.
- Extensive knowledge of various dental benefit models (FFS Indemnity PPO EPO DHMO Discount Medicaid Medicare Advantage).
- Ideally has at least 10 years experience in the dental industry including 25 years of direct provider-side experience.
- Experience working with dental insurance payors (or within a payor organization) is highly advantageous.
- Equivalent combinations of education and relevant experience will be considered.
Compensation:
- Salary Range between $125000 - $150000 with a 10% annual corporate bonus
Required Experience:
Director
Key Skills
- Revenue Cycle Management
- Marketing
- Public Relations
- Algebra
- MailChimp
- Media Relations
- Social Listening
- Relationship Management
- Customer relationship management
- Medicare
- Public Speaking
- Writing Skills
About Company
Discover InterDent's extensive support for dental professionals and how we enable high-quality, convenient patient care across the USA.
