Description
Sun 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.
Job Description:
The Opportunity:
This is a hybrid role, requiring Monday and Friday in office at our Nashville Location
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 do:
Payor Relations, Contracting & Fee Negotiation
- Lead enterprise-wide payor relations strategy, including contract negotiations, fee schedule negotiations, renewals, amendments, and dispute resolution
- Negotiate reimbursement rates and fee schedules for PPO, Medicaid, and capitation plans to support organizational financial goals
- Build and maintain strong working relationships with commercial and government payors
- Serve as the primary escalation point for complex payor issues impacting reimbursement, access, or compliance
- Partner with RCM leadership to assess financial and operational impact of payor contracts and policy changes
- Collaborate with Operations and Clinical leadership to support expansion, onboarding, and market entry initiatives
Credentialing & Provider Enrollment
- Oversee provider credentialing and enrollment processes across all markets and payors
- Lead implementation, optimization, and ongoing management of credentialing software platforms
- Update TIN's with Payors as a practice is onboarded/acquired
- Maintain licensing records of providers
- Manage expiring credentials with payors
- Manage payor portal users, access controls, and permissions to ensure security, compliance, and operational efficiency
- Ensure timely onboarding and offboarding of providers in alignment with operational and clinical timelines
- Establish standardized workflows, SLAs, and tracking mechanisms to reduce credentialing-related revenue delays
- Ensure compliance with regulatory, payor, and accreditation requirements
Team Leadership & Development
- Lead, mentor, and develop a team of credentialing and payor relations specialists
- Set clear performance expectations, goals, and accountability metrics
- Foster a collaborative, high-performing team culture aligned with RCM objectives
- Partner with RCM leadership on workforce planning, training, and scalability initiatives
Cross-Functional Collaboration
- Work closely with RCM operations, billing, AR, and reporting teams to resolve payor-related issues
- Collaborate with Operations and Clinical teams to support provider lifecycle management
- Participate in cross-functional planning related to growth, acquisitions, and organizational changes
- Provide clear communication and updates to leadership regarding payor risks, trends, and opportunities
Special Projects & Additional Responsibilities
- Lead or support special projects and strategic initiatives as assigned by RCM leadership
- Adapt to evolving business needs and assume additional responsibilities as required to support departmental and organizational objectives
- Perform other duties as assigned to support business needs
Reporting & Continuous Improvement
- Monitor key performance indicators related to credentialing timelines, payor responsiveness, fee performance, and revenue impact
- Identify process gaps and implement improvements to enhance efficiency and reduce risk
- Support audits, payor inquiries, and internal reviews as needed
What you will bring with you:
- 10+ years of progressive experience in payor relations, contracting, credentialing, and fee negotiations, hands-on experience working with PPO, Medicaid, and capitation-based reimbursement models
- Â 5+ years of experience managing multi-state Medicaid plans
- Required experience working within large Dental Service Organizations (DSOs) or large multi-practice dental enterprises
- Proven experience negotiating payor contracts and fee schedules
- Demonstrated ability to lead and develop credentialing and payor relations teams
- History working in credentialing software platforms such as Medallion and/or CredentialStream
- Experience implementing and managing credentialing software solutions
- Strong understanding of Revenue Cycle Management operations and workflows
- Experience working closely with Operations and Clinical teams in provider onboarding and offboarding
- Excellent written and verbal communication skills
- Strong organizational, problem-solving, and decision-making abilities
Preferred Qualifications
- Dental credentialing and payor relations experience strongly preferred; medical credentialing experience will be considered
- Experience supporting growth, acquisitions, or large-scale onboarding initiatives
Core Competencies
- Strategic leadership
- Payor and fee negotiation expertise
- Credentialing and enrollment management
- Cross-functional collaboration
- Operational execution
- Communication and stakeholder management
- Process improvement and scalability
At 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: 101,000-151,500
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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 Life
At 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.
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