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Sage Dental · 1 day ago

Sr Director, Payer Relations

Boca Raton, FL

Full-time

Hybrid

Director/Executive

10+ years exp

Sage Dental Partners is a leading Dental Service Organization committed to innovation, excellence, and patient-centered care. The Senior Director of Payer Relations is responsible for the strategic development, negotiation, and ongoing management of all payer contracts, ensuring alignment with organizational objectives for growth and compliance with regulations.

Health CareMedical

Growth Opportunities

Responsibilities

Develop and execute the organization’s payer strategy to ensure sustainable, market-competitive reimbursement models across all dental specialties (General, Orthodontic, Pediatric, Oral Surgery, and Specialty Care)

Lead contract and fee schedule negotiations, renewals, and amendments with commercial and government payers

Establish strategic partnerships with payers to support network growth, reimbursement innovation, and value-based care initiatives

Collaborate with Operations, Clinical, and Finance leadership to align payer strategies with patient access, care delivery, and financial goals

Oversee the negotiation, review, and execution of all payer agreements and related amendments

Manage payer onboarding and credentialing workflows in collaboration with the Credentialing and Enrollment teams

Ensure accurate fee schedule loading, maintenance, and validation in practice management systems

Develop and maintain payer performance dashboards to monitor reimbursement trends, rate changes, and operational impact

Maintain comprehensive understanding of CMS regulations, including Medicare Advantage, CHIP, and state Medicaid programs affecting dental benefits

Serve as a policy liaison, interpreting and communicating payer, CMS, and state-level regulatory changes to executive and operational stakeholders

Partner with Legal and Compliance teams on payer audit responses, contract disputes, and government program participation requirements

Ensure all payer contracts and internal processes adhere to federal and state laws governing reimbursement and network participation

Collaborate with Revenue Cycle, Finance, and Analytics to identify reimbursement opportunities, contract leakage, and underpayment trends

Lead reimbursement modeling and financial impact analysis for new payer contracts, rate changes, and practice acquisitions

Contribute to annual budgeting and forecasting processes by providing contract-based revenue projections and rate updates

Monitor payer performance metrics such as rate realization, denial rates, and claim turnaround times

Lead a multi-disciplinary team including Payer Relations Managers, Contract Analysts, and Credentialing Specialists

Foster a culture of accountability, collaboration, and continuous process improvement

Provide coaching, mentorship, and professional development opportunities to enhance payer relations expertise across the department

Qualification

Payer relationsManaged care contractingHealthcare reimbursementCMS regulationsFinancial acumenStakeholder managementNegotiation skillsTeam developmentLeadershipCommunication skills

Required

Bachelor's degree in Business, Healthcare Administration, Finance, or related field required

Minimum 10 years' progressive experience in payer relations, managed care contracting, or healthcare reimbursement, with at least 5 years in a leadership role

Proven success negotiating dental payer contracts and managing multi-state network relationships

Deep understanding of CMS (Medicare/Medicaid) regulations and state-specific payer policy frameworks

Strong financial acumen and experience with fee schedule modeling, reimbursement analytics, and value-based care initiatives

Excellent negotiation, communication, and stakeholder management skills

Demonstrated ability to navigate complex multi-payer environments and support organizational growth initiatives

Remote position; some travel required (approximately 15–25%) for payer meetings, market visits, and industry conferences