DIRECTOR OF PAYOR RELATIONS

Job Description

Job Description

Position Overview

Apex Skin We are seeking a highly skilled and motivated Director of Payor Relations to join our dynamic team. The Director of Payor Relations is responsible for developing and managing strategic relationships with health insurance payors, third-party administrators, and government programs to ensure optimal contract performance, reimbursement, and compliance. This role leads contract negotiations, manages payor performance, and collaborates with internal departments to align payor strategies with organizational goals. Reporting directly to the CFO this position will be a key member of the Finance leadership team.

This is a Full-time position. This position requires legal authorization to work in the US.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Contract Management & Negotiation:
  • Lead and manage all phases of commercial and government payor contract negotiations, including fee schedules, terms, and value-based arrangements.
  • Analyze contract performance and make data-driven recommendations to optimize reimbursement and financial outcomes.
  • Monitor and ensure compliance with payor contract terms and regulatory requirements.
• Payor Relationship Development:
  • Cultivate and maintain strategic partnerships with key representatives from payor organizations.
  • Serve as the primary liaison for all contract-related discussions and dispute resolutions with payors.
  • Advocate on behalf of the organization to ensure fair and equitable reimbursement.
• Strategy & Analytics:
  • Develop and implement a payor strategy aligned with the organization’s financial and clinical objectives, including strategic renegotiation of existing contracts, value-based care initiatives, and alternative payment models such as direct employer contracts, self-funded plans, and others.
  • Monitor payor trends, legislative developments, and industry best practices to inform strategy and mitigate risks.
  • Work with finance, legal, clinical, and revenue cycle teams to evaluate performance and optimize managed care contracts.
• Collaboration & Communication:
  • Act as a subject matter expert for internal stakeholders on payor issues, contract
  • interpretation, and reimbursement policy.
  • Collaborate with external PHO partner to ensure alignment of internal / external contracts

Qualifications

• Education: Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field required.
• Experience: 7 – 10 years of experience in managed care contracting, payor relations, or
• healthcare administration.
• Demonstrated success in negotiating payor contracts and managing complex relationships.
• Experience in both commercial and government payor environments.

Key Competencies

• Strong negotiation, analytical, and strategic planning skills
• Excellent interpersonal and communication skills; interact positively and constructively
• with staff, clients, and other members of Apex leadership
• Knowledge of regulatory issues, reimbursement methodologies, and value-based care models.
• Self-motivated with a positive and exceptional work ethic and attention to detail
• Excellent analytical, problem-solving, and organizational skills
• Ability to work independently or collaboratively, in a fast-paced environment, and manage multiple priorities
• Proficient with Microsoft Office suite

About Us.......Who We Are

We are Apex Skin. Our goal is to provide the highest quality dermatology and dermatologic surgery care to patients in Northeast Ohio in a prompt and compassionate manner. A strong commitment to delivering an exceptional patient experience, prompt access to care, including same day appointments, and service and education to the community are our core values.

What We Offer

Apex Skin offers a comprehensive benefits plan that includes a Monday thru Friday schedule, Paid Time Off, Paid Holidays, Holidays off, Medical, Dental, Vision, Life Insurance, Short-Term Disability and 401(k), Discounts on Derm services, Travel and leisure discounts, sporting event, concert and special event discounts, discounted movie tickets and more!

Apex Skin provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Apex complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.