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Payor Relations Manager - Job Opportunity at Specialty1 Partners

Remote, US
Full-time
Senior
Posted: March 7, 2025
Remote
USD 110,000 - 150,000 annually based on role seniority and healthcare sector compensation trends

Benefits

Comprehensive BCBS Medical Insurance with HDH and PPO options - Above market standard healthcare coverage
Premium VSP Vision Coverage with expanded network access
Competitive PPO Dental Insurance with preventive care focus
Company-paid Life Insurance demonstrating strong employee protection
Comprehensive Disability Coverage (Short & Long-term) for income protection
Unique Pet Insurance Coverage - Shows progressive benefits approach
401(k) Plan with company support
Dual HSA/FSA Options for maximum tax advantage
Identity Theft Protection - Modern security benefit
Legal Services Package - Comprehensive personal support
Supplemental Hospital/Accident/Critical Care Coverage
Generous Paid Time Off Policy
Progressive DEI-focused work environment
Team-oriented culture with emphasis on integrity

Key Responsibilities

Strategic Leadership in Payor Relations: Direct development and management of insurance payor relationships to optimize reimbursement structures
Financial Performance Optimization: Lead contract negotiations to secure competitive rates while maintaining quality care standards
Cross-functional Collaboration: Orchestrate initiatives with Revenue Cycle Management, Operations, and Clinical Leadership
Market Intelligence Management: Monitor and analyze industry trends to guide strategic decisions
Stakeholder Relations: Serve as primary liaison between payors and practices, managing complex relationships
Process Improvement: Design and implement reimbursement optimization strategies
Strategic Network Management: Develop insurance participation strategies for market positioning
Compliance Oversight: Ensure adherence to regulatory requirements through partnership with legal teams
Educational Leadership: Provide strategic guidance on payor policies and industry trends
Performance Analytics: Direct KPI tracking and analysis for contract effectiveness
Operational Enhancement: Streamline provider enrollment and credentialing processes
Strategic Partnership Development: Identify and cultivate payor partnerships for competitive advantage

Requirements

Education

Bachelor's degree in business, healthcare administration, finance, or related field (Master's preferred)

Experience

Minimum of 5 years of experience in payor relations, managed care contracting, revenue cycle management, or healthcare reimbursement

Required Skills

In-depth knowledge of payor contracting Strong negotiation and contract management skills Data analysis capabilities Communication and interpersonal skills Problem-solving abilities Organizational skills Proficiency in Microsoft Office Suite Experience with healthcare software systems Business acumen Contract management expertise Strategic planning capabilities
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Sauge AI Market Intelligence

Industry Trends

Healthcare reimbursement models are rapidly evolving toward value-based care, requiring sophisticated negotiation and analytics capabilities in payor relations roles. The consolidation of specialty dental practices is creating new opportunities for scaled payor negotiations and network optimization. Digital transformation in healthcare billing and claims processing is driving demand for technically savvy payor relations professionals. Increasing focus on specialty care networks is creating unique opportunities for differentiated reimbursement strategies.

Role Significance

Typically leads a team of 3-5 specialists while coordinating with multiple departmental stakeholders
Senior management position with strategic influence on organizational financial performance and network development

Key Projects

Large-scale payor contract negotiations and renewals Network optimization initiatives Revenue cycle improvement programs Payor relationship development strategies Compliance and regulatory adaptation projects

Success Factors

Deep understanding of healthcare reimbursement models and trends Strong negotiation skills combined with analytical capabilities Ability to build and maintain relationships with diverse stakeholders Strategic thinking with practical implementation skills Balance of financial optimization with quality care delivery

Market Demand

High demand position due to complex healthcare reimbursement landscape and growing specialty practice networks

Important Skills

Critical Skills

Payor contract negotiation expertise - Essential for driving practice revenue performance Healthcare reimbursement knowledge - Critical for optimizing payment structures Relationship management - Key to maintaining effective payor partnerships Analytics capabilities - Crucial for data-driven decision making

Beneficial Skills

Project management experience Change management skills Healthcare technology familiarity Quality metrics understanding

Unique Aspects

Focus on specialty dental practices provides unique payor relationship opportunities
Rapid organizational growth creates dynamic career opportunities
Balance of centralized support with practice autonomy
Multi-specialty focus enables diverse reimbursement strategy development

Career Growth

2-4 years in role before advancement, depending on organizational growth and performance

Potential Next Roles

Director of Managed Care VP of Payor Strategy Chief Revenue Officer Healthcare Operations Executive

Company Overview

Specialty1 Partners

Specialty1 Partners represents a modern healthcare services organization focused on specialty dental practice support, demonstrating significant growth since 2019

Major player in specialty dental practice management with over 225 locations across 28 states
National footprint with strong presence in multiple regions, enabling significant payor negotiating leverage
Professional services environment with emphasis on specialist autonomy and business support excellence
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  • Salary estimates and market demand analysis
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  • Critical success factors and key skills
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