Associate Director, RCM Payor Relations

Associate Director of Payor Relations Senior leadership role within the Revenue Cycle Management (RCM) organization, responsible for overseeing payor relations, contracting, credentialing, and fee negotiation functions across the enterprise. Payor Relations, Contracting & Fee Negotiation 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. Credentialing & Provider Enrollment Oversee provider credentialing and enrollment processes across all markets and payors. Lead implementation, optimization, and ongoing management of credentialing software platforms. Update TINs with payors as a practice is onboarded or 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. Team Leadership & Development 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. Cross-Functional Collaboration Work closely with RCM operations, billing, accounts receivable, 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. Special Projects & Additional Responsibilities 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. Reporting & Continuous Improvement 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. Qualifications 10+ years of progressive experience in payor relations, contracting, credentialing, and fee negotiations, hands‑on experience 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 with 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. Preferred Qualifications Dental credentialing and payor relations experience strongly preferred; medical credentialing experience will be considered. Experience supporting growth, acquisitions, or large‑scale onboarding initiatives. Core Competencies Strategic leadership Payor and fee negotiation expertise Credentialing and enrollment management Cross‑functional collaboration Operational execution Communication and stakeholder management Process improvement and scalability Benefits & Compensation Salary Range: $101,000 – $151,500 (competitive nationwide). The position is eligible for a discretionary annual incentive award based on individual performance and overall business performance. Comprehensive benefits include generous vacation and sick time, market‑leading paid family, parental and adoption leave, medical coverage, company‑paid life and AD&D insurance, disability programs, partially paid sabbatical program, 401(k) employer match, stock purchase options, and an employer‑funded retirement account. Equal Opportunity Employer Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Accommodation Statement We will make reasonable accommodations to the known physical or mental limitations of otherwise‑qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email View email address on click.appcast.io to request an accommodation. California Privacy Notice For applicants residing in California, please read our employee California Privacy Policy and Notice. Other Employment Policies We do not require or administer lie detector tests as a condition of employment or continued employment. #J-18808-Ljbffr Sun Life