Associate Director, RCM Payor Relations

The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.Associate Director, RCM Payor RelationsThe insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.DescriptionSun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.Job DescriptionThe Opportunity:This is a hybrid role, requiring Monday and Friday in office at one of our core office locations. The Associate Director of Payor Relations is a senior leadership role within the Revenue Cycle Management (RCM) organization, responsible for overseeing all payor relations, contracting, credentialing, and fee negotiation functions across the enterprise. This role leads the Payor Relations and Credentialing teams, ensuring strong payor partnerships, compliant provider onboarding and offboarding, and alignment with operational and clinical priorities.This position works closely with RCM leadership, Operations, Clinical teams, and external payors to support growth, mitigate revenue risk, and ensure timely reimbursement through effective contract management, credentialing execution, and relationship oversight. The Associate Director may also be assigned special projects and initiatives in support of organizational and departmental priorities.The essential functions and responsibilities of this job position include, but are not limited to the following:What You Will DoPayor Relations, Contracting & Fee NegotiationLead enterprise-wide payor relations strategy, including contract negotiations, fee schedule negotiations, renewals, amendments, and dispute resolutionNegotiate reimbursement rates and fee schedules for PPO, Medicaid, and capitation plans to support organizational financial goalsBuild and maintain strong working relationships with commercial and government payorsServe as the primary escalation point for complex payor issues impacting reimbursement, access, or compliancePartner with RCM leadership to assess financial and operational impact of payor contracts and policy changesCollaborate with Operations and Clinical leadership to support expansion, onboarding, and market entry initiativesCredentialing & Provider EnrollmentOversee provider credentialing and enrollment processes across all markets and payorsLead implementation, optimization, and ongoing management of credentialing software platformsUpdate TIN's with Payors as a practice is onboarded/acquiredMaintain licensing records of providersManage expiring credentials with payorsManage payor portal users, access controls, and permissions to ensure security, compliance, and operational efficiencyEnsure timely onboarding and offboarding of providers in alignment with operational and clinical timelinesEstablish standardized workflows, SLAs, and tracking mechanisms to reduce credentialing-related revenue delaysEnsure compliance with regulatory, payor, and accreditation requirementsTeam Leadership & DevelopmentLead, mentor, and develop a team of credentialing and payor relations specialistsSet clear performance expectations, goals, and accountability metricsFoster a collaborative, high-performing team culture aligned with RCM objectivesPartner with RCM leadership on workforce planning, training, and scalability initiativesCross-Functional CollaborationWork closely with RCM operations, billing, AR, and reporting teams to resolve payor-related issuesCollaborate with Operations and Clinical teams to support provider lifecycle managementParticipate in cross-functional planning related to growth, acquisitions, and organizational changesProvide clear communication and updates to leadership regarding payor risks, trends, and opportunitiesSpecial Projects & Additional ResponsibilitiesLead or support special projects and strategic initiatives as assigned by RCM leadershipAdapt to evolving business needs and assume additional responsibilities as required to support departmental and organizational objectivesPerform other duties as assigned to support business needsReporting & Continuous ImprovementMonitor key performance indicators related to credentialing timelines, payor responsiveness, fee performance, and revenue impactIdentify process gaps and implement improvements to enhance efficiency and reduce riskSupport audits, payor inquiries, and internal reviews as neededWhat You Will Bring With You10+ years of progressive experience in payor relations, contracting, credentialing, and fee negotiations, hands-on experience working with PPO, Medicaid, and capitation-based reimbursement models 5+ years of experience managing multi-state Medicaid plansRequired experience working within large Dental Service Organizations (DSOs) or large multi-practice dental enterprisesProven experience negotiating payor contracts and fee schedulesDemonstrated ability to lead and develop credentialing and payor relations teamsHistory working in credentialing software platforms such as Medallion and/or CredentialStreamExperience implementing and managing credentialing software solutionsStrong understanding of Revenue Cycle Management operations and workflowsExperience working closely with Operations and Clinical teams in provider onboarding and offboardingExcellent written and verbal communication skillsStrong organizational, problem-solving, and decision-making abilitiesPreferred QualificationsDental credentialing and payor relations experience strongly preferred; medical credentialing experience will be consideredExperience supporting growth, acquisitions, or large-scale onboarding initiativesCore CompetenciesStrategic leadershipPayor and fee negotiation expertiseCredentialing and enrollment managementCross-functional collaborationOperational executionCommunication and stakeholder managementProcess improvement and scalabilityAt our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. National Average Salary Range: 101,000-151,500Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.Life is brighter when you work at Sun LifeAt Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work® Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.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 thebrightside@sunlife.com to request an accommodation.For applicants residing in California, please read our employee California Privacy Policy and Notice.We do not require or administer lie detector tests as a condition of employment or continued employment.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.Job CategoryBusiness Analysis - ProcessPosting End Date31/05/2026