Payor Optimization Manager

SGA Dental Partners is seeking a detail-oriented, proactive Payor Optimization Manager to lead payor contracting, credentialing, and insurance support functions.

Responsibilities

• Lead, supervise, train, and develop credentialing and insurance contract support teams to ensure accuracy, efficiency, and performance.
• Support the full payer contracting lifecycle, including provider onboarding, applications, renewals, and contract execution.
• Maintain strong relationships with payer partners to support contract negotiations, reimbursement optimization, and long-term collaboration.
• Support contract negotiations to secure favorable terms, reimbursement rates, and conditions for dental services.
• Oversee contracting and credentialing workflows, including pending contracts, re-credentialing, new locations, missing documentation, and payer updates.
• Conduct market and payer landscape analysis to identify trends, risks, and opportunities impacting strategy and reimbursement.
• Develop and execute payer strategies aligned with organizational goals to improve financial performance and operational efficiency.
• Utilize data analytics and reporting to evaluate contract performance and identify areas for improvement.
• Ensure compliance with all applicable healthcare regulations, payer requirements, and internal policies.
• Collaborate cross-functionally with finance, operations, clinical, and revenue cycle teams to align payer strategies and improve workflows.
• Communicate effectively with offices and stakeholders during contract changes, renewals, and payer updates.
• Identify and support process improvement and workflow optimization initiatives.
• Maintain strict adherence to regulatory and documentation standards across all payer and credentialing activities.
• Perform additional administrative or operational duties as assigned.

Requirements

• 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.
• 5+ years of leadership or supervisory experience preferred.
• Strong understanding of insurance payor processes, credentialing standards, and provider data management.

Skills

• 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.

Benefits

• Paid Holidays and Paid Time Off (PTO).
• 401(k) Retirement Plan.
• Health and Vision Insurance.
• Employer-Paid Dental Insurance, Life Insurance, Care.com Membership & Employee Assistance Program.
• Supplemental Coverage (Disability, Critical Illness, Accident).
• Career Growth and Development Opportunities.

Schedule

Monday - Friday, 8:00 AM - 5:00 PM.