Director of Payer Relations

Priory

Director of Payer Relations at Marvin Behavioral Health overseeing payer strategies, contracts, and provider credentialing. This hybrid role requires collaboration with various teams while focusing on external payer relationships.

Posted 7/15/2026full-timeLos Angeles • California, Colorado, New York • 🇺🇸 United StatesLead💰 $110,000 - $150,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in payer contracting, fee schedule management, and provider credentialing within the healthcare revenue cycle management domain. Proficient in negotiating contracts, ensuring compliance with regulations, and collaborating with cross-functional teams to optimize reimbursement processes.

Highest-signal resume keywords

Payer Contract NegotiationFee Schedule ManagementProvider CredentialingAdvancedMD ProficiencyBehavioral Health Expertise

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CPT CodingHCPCS CodingICD-10 CodingReimbursement AnalysisPayer Relations Management

Soft Skills

CommunicationProblem-SolvingRelationship ManagementLeadership

Tools & Technologies

EHR SystemsPractice Management SystemsClearinghouses

Certifications & Qualifications

Bachelor's Degree in Healthcare AdministrationFinanceBusiness

Industry Keywords

Revenue Cycle ManagementBehavioral HealthPayer PoliciesMental Health Parity LawsBilling Regulations

About the role

Key responsibilities & impact

Own the full lifecycle of all payer contracts: negotiation, execution, renewal, and ongoing performance monitoring
Analyze payer fee schedules and reimbursement rates across all contracts; identify underpayment gaps and drive renegotiation to improve rates
Maintain and update the practice's chargemaster and fee schedules in the EHR/practice management system (AdvancedMD); ensure rates are accurate and current across all payers and service lines
Conduct annual fee schedule reviews in partnership with Finance to ensure contracted rates remain strategically aligned with the cost of care
Ensure compliance with payer policies, mental health parity laws, and applicable state and federal billing regulations
Serve as the primary point of contact for all payer representatives; maintain direct, active relationships and know who to call to get things done
Personally escalate and resolve complex payer disputes, wrongful denials, and underpayment issues that require direct payer intervention
Write and oversee escalated appeal letters; ensure appeals are clinically supported, accurate, and submitted within timely filing requirements
Monitor payer policy changes and communicate impacts to clinical, compliance, and billing teams proactively
Ensure fee schedules are correctly loaded in AdvancedMD for every payer and updated promptly when contracts change
Audit reimbursements against contracted rates to identify systematic underpayments; initiate recovery and corrective action
Track fee schedule performance across payers and present findings and recommendations to executive leadership
Partner with Finance on chargemaster strategy to ensure billed charges reflect the appropriate markup above contracted rates
Oversee the credentialing function; ensure all providers are credentialed and enrolled with relevant payers accurately and on time
Maintain an accurate credentialing database tracking licensure, certifications, DEA, malpractice coverage, and all expirables; manage renewals proactively
Personally step in on complex enrollment issues, payer rejections, or credentialing disputes that require escalation
Manage re-credentialing cycles and oversee responses to payer audits or corrective action requests related to provider enrollment
Own revenue readiness for every new partner or plan launch: ensure the right contracts are in place, providers are credentialed, and systems are configured before the first claim is submitted
Collaborate with internal teams to map out the full billing setup: payer mix, covered services, fee schedules, authorization requirements, and billing rules
Lead system configuration in AdvancedMD for new payers and partners: fee schedule loading, payer enrollment linkage, and claim routing
Build and maintain a launch readiness checklist and timeline; flag risks early and drive cross-functional accountability to close gaps
Serve as the RCM subject matter expert in partner implementation conversations, translating payer and billing requirements into plain language for operational and clinical stakeholders
Review RCM KPIs and dashboards regularly and identify issues requiring payer-level intervention
Collaborate with Clinical, Compliance, Legal, and Finance teams to align revenue cycle practices with organizational strategy and regulatory requirements

Requirements

What you’ll need

Bachelor's degree in Healthcare Administration, Finance, Business, or related field
7+ years of progressive RCM experience in healthcare, with at least 3 years in a leadership role
Deep, hands-on experience in behavioral health payer contracting, fee schedule management, and payer relations
Demonstrated track record of negotiating payer contracts and improving reimbursement rates
Direct ownership of provider credentialing and payer enrollment processes
Proficiency with EHR/practice management systems (AdvancedMD preferred) and clearinghouses
Strong command of CPT, HCPCS, and ICD-10 coding in a behavioral health context
Experience supporting partner or plan launches: contracts, credentialing, and system setup prior to go-live
Comfort engaging payers directly — including making calls, writing appeals, and attending payer meetings.

Benefits

Comp & perks

Competitive salary
Offers Equity