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Job description
Description
The 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.
Description
The 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, CA
Pay Range:
$115,000 - $130,000 DOE + Bonus Plan
KeyResponsibilities:
Serve as the primary point of contact for assigned payors,maintainingstrong, proactive relationships
Conduct regular business reviews and check-ins with payor representatives
Identifyrisks to payor relationships and develop mitigation strategies
Partner with internal teams (clinical, revenue cycle, operations) to ensure alignment with payor expectations
Document and updateCRMwith payor contacts and activity weekly
Review and update provider portals and directories
Payor Performance & Outcomes Reporting:
Develop and deliver compelling, data-driven presentationsdemonstratingclinical outcomes, quality metrics, and value of ABA services
Translate 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 payors
Continuouslyrefinereporting frameworks to strengthen the organization’s value proposition
Rate Strategy & Negotiation:
Identifyopportunities for rate increases based on performance, market benchmarks, and outcomes
Prepare and present rate increase proposals supported by data and financial modeling
Lead negotiations with payors to improve reimbursement rates and terms
Track and analyze reimbursement trends to inform negotiation strategy
Contract Retention & Growth:
Drive retention of existing payor agreements through proactive engagement anddemonstratedvalue
Support expansion of services within existing payor relationships (e.g., new markets, service lines)
Monitor contract performance and elevate issuesimpactingretention
Cross-Functional Collaboration:
Collaborate with Revenue Cycle to address denial trends, underpayments, and operational friction points
Partner with Clinical Leadership toalign onoutcomes reporting and quality metrics
Work with Finance to evaluatefinancial impactof rate changes and payor mix
Market Intelligence:
Monitor industry trends in ABA reimbursement, payor policies, and competitive positioning
Provide insightstoleadership on payor strategy and risks/opportunities
Key Performance Indicators (KPIs):
Number of payor presentations delivered (monthly/quarterly)
Number of rate increase requests submitted
Average reimbursement rate improvement (%)
Payor contract retention rate (%)
Success rate of rate negotiations
Growth in revenue tied torateimprovements or strengthened payor relationships
Payor satisfaction / relationship health (qualitative + survey-based)
QualificationsRequired
Bachelor’s degree in Healthcare Administration, Business, Finance, or related field
5-10 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 presentations
Strong analytical skills with ability to interpret and present clinical and financial data
Deep understanding of reimbursement in ABA and/or behavioral health
Preferred
Experience in multi-state ABA provider organizations
Familiarity with Medicaid and commercial payor dynamics in autism services
Advanced degree (MBA, BHA)
Skill & Competencies
Executive-levelcommunication and presentation skills
Negotiation and influencing skills
Data storytelling and visualization
Strategic thinking with strong business acumen
Relationship management and stakeholder engagementProblem-solving and cross-functional collaboration
Why 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 employment
Paid Personal Time Off
Paid Holidays
Paid Sick Leave
Medical, Dental and Vision insurance
Opportunities for career advancement
Performance and promotionraises
Free Telehealth:Free access to a doctor via telehealth for you and your dependents with no limits and no co-pays
Free 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-pays
Employee 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 videos
Deals: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 work
New Benefits Rx:Discounts on prescription medications from 10-80%at60,000+ locations nationwide
Why work for Behavior Frontiers? Visit our benefits & perks page tolearn 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.
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Worksite address
el segundo, CA, 90245, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.