Director of Payor Relations

DescriptionThe Director of Payor Relations is responsible for developing, managing, and strengthening relationships with commercial and government payors to support the organization’s Applied Behavior Analysis (ABA) services. This role focuses on optimizing reimbursement, improving contract performance, and ensuring long-term payor partnership through data-driven storytelling, outcomes reporting, and strategic rate negotiations.This position plays a critical role inongoingpayorengagement, retention, and financial performance improvement.Office Location: El Segundo, CAPay Range: $115,000 - $130,000 DOE + Bonus Plan  KeyResponsibilities: Payor Relationship ManagementServe as the primary point of contact for assigned payors,maintainingstrong, proactive relationshipsConduct regular business reviews and check-ins with payor representativesIdentifyrisks to payor relationships and develop mitigation strategiesPartner with internal teams (clinical, revenue cycle, operations) to ensure alignment with payor expectationsDocument and updateCRMwith payor contacts and activity weeklyReview and update provider portals and directoriesPayor Performance & Outcomes ReportingDevelop and deliver compelling, data-driven presentationsdemonstratingclinical outcomes, quality metrics, and value of ABA servicesTranslate clinical and operational data into clear narratives tailored to payor priorities (e.g., cost savings, member outcomes, access)Lead quarterly or semi-annual business reviews with payorsContinuouslyrefinereporting frameworks to strengthen the organization’s value propositionRate Strategy & NegotiationIdentifyopportunities for rate increases based on performance, market benchmarks, and outcomesPrepare and present rate increase proposals supported by data and financial modelingLead negotiations with payors to improve reimbursement rates and termsTrack and analyze reimbursement trends to inform negotiation strategyContract Retention & GrowthDrive retention of existing payor agreements through proactive engagement anddemonstratedvalueSupport expansion of services within existing payor relationships (e.g., new markets, service lines)Monitor contract performance and escalate issuesimpactingretentionCross-Functional CollaborationCollaborate with Revenue Cycle to address denial trends, underpayments, and operational friction pointsPartner with Clinical Leadership toalign onoutcomes reporting and quality metricsWork with Finance to evaluatefinancial impactof rate changes and payor mixMarket IntelligenceMonitor industry trends in ABA reimbursement, payor policies, and competitive positioningProvide insightstoleadership on payor strategy and risks/opportunitiesKey Performance Indicators (KPIs)Number of payor presentations delivered (monthly/quarterly)Number of rate increase requests submittedAverage reimbursement rate improvement (%)Payor contract retention rate (%)Success rate of rate negotiationsGrowth in revenue tied torateimprovements or strengthened payor relationshipsPayor satisfaction / relationship health (qualitative + survey-based)QualificationsRequiredBachelor’s degree in Healthcare Administration, Business, Finance, or related field5-10 years of experience in payor relations, managed care, or healthcare contracting (ABA or behavioral health strongly preferred)Demonstrated experience with rate negotiations and payor-facing presentationsStrong analytical skills with ability to interpret and present clinical and financial dataDeep understanding of reimbursement in ABA and/or behavioral healthPreferredExperience in multi-state ABA provider organizationsFamiliarity with Medicaid and commercial payor dynamics in autism servicesAdvanced degree (MBA, BHA)Skill & CompetenciesExecutive-levelcommunication and presentation skillsNegotiation and influencing skillsData storytelling and visualizationStrategic thinking with strong business acumenRelationship management and stakeholder engagementProblem-solving and cross-functional collaborationWhy Behavior Frontiers is perfect for you:Competitive pay with optional On-demand paychecksthruDailyPay- get paid on your own schedule!401K Plan with company match after 6 months of employmentPaid Personal Time OffPaid HolidaysPaid Sick LeaveMedical, Dental and Vision insuranceOpportunities for career advancementPerformance and promotionraisesFree Telehealth: Free access to a doctor via telehealth for you and your dependents with no limits and no co-paysFree Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-paysEmployee Assistance Program: Free access tosome supportservices (financial, legal, counseling, etc.)Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videosDeals: Exclusive discounts and savings to 500+ companies and more!Travel: Discounts on travel essentials including hotels, rental cars, flights, excursions, and more!Lab Testing Discounts: 10-80% off costs of routine lab workNew Benefits Rx: Discounts on prescription medications from 10-80%at60,000+ locations nationwideWhy work for Behavior Frontiers? Visit our benefits & perks page to learn more!Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.