Associate Director, RCM Payor Relations

Associate Director of Payor Relations A senior leadership role within the Revenue Cycle Management organization responsible for overseeing all payor relations, contracting, credentialing, and fee negotiation functions across the enterprise. This position leads the Payor Relations and Credentialing teams, works closely with RCM leadership, operations, clinical teams, and external payors to support growth, mitigate revenue risk, and ensure timely reimbursement. Key Responsibilities Lead enterprise‑wide payor relations strategy, including contract negotiations, fee schedule negotiations, renewals, amendments, dispute resolution. Negotiate reimbursement rates and fee schedules for PPO, Medicaid, and capitation plans. Build and maintain strong working relationships with commercial and government payors. Serve as 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 on 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. Maintain licensing records, manage expiring credentials, and enforce compliance with regulatory, payor, and accreditation requirements. Lead, mentor, and develop a team of credentialing and payor relations specialists. Work closely with RCM operations, billing, AR, and reporting teams to resolve payor‑related issues. 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 required. 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. Experience working within large Dental Service Organizations (DSOs) or large multi‑practice dental enterprises. Proven negotiation experience with payor contracts and fee schedules. Leadership experience developing credentialing and payor relations teams. Experience with credentialing software solutions such as Medallion and/or CredentialStream. Strong understanding of Revenue Cycle Management operations and workflows. Excellent written and verbal communication skills. Strong organizational, problem‑solving, and decision‑making abilities. Preferred Qualifications Dental credentialing and payor relations experience; medical credentialing experience will be considered. Experience supporting growth, acquisitions, or large‑scale onboarding initiatives. Benefits & Compensation Salary range: $101,000–$151,500 annually, with a discretionary annual incentive award based on individual and company performance. Additional 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, a partially paid sabbatical program, 401(k) with employer match, stock purchase options, and an employer‑funded retirement account. Equity & Accessibility Statement We will make reasonable accommodations for individuals with disabilities or veterans unless an undue hardship is imposed. Please email View email address on click.appcast.io for accommodation requests. EEO Statement 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. Sun Life considers all qualified applicants, including those with criminal histories, in accordance with applicable state and local laws. #J-18808-Ljbffr Sun Life Financial