Director of Payor Relations

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 in ongoing payor engagement, retention, and financial performance improvement.

Office Location: El Segundo, CA 
Pay Range: $115,000 - $130,000 DOE + Bonus Plan  

Key Responsibilities:  

Payor Relationship Management 

• Serve as the primary point of contact for assigned payors, maintaining strong, proactive relationships  

• Conduct regular business reviews and check-ins with payor representatives  

• Identify risks to payor relationships and develop mitigation strategies  

• Partner with internal teams (clinical, revenue cycle, operations) to ensure alignment with payor expectations 

• Document and update CRM with payor contacts and activity weekly 

• Review and update provider portals and directories 

Payor Performance & Outcomes Reporting 

• Develop and deliver compelling, data-driven presentations demonstrating clinical 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  

• Continuously refine reporting frameworks to strengthen the organization’s value proposition 

Rate Strategy & Negotiation 

• Identify opportunities 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 and demonstrated value  

• Support expansion of services within existing payor relationships (e.g., new markets, service lines)  

• Monitor contract performance and escalate issues impacting retention 

Cross-Functional Collaboration 

• Collaborate with Revenue Cycle to address denial trends, underpayments, and operational friction points  

• Partner with Clinical Leadership to align on outcomes reporting and quality metrics  

• Work with Finance to evaluate financial impact of rate changes and payor mix  

Market Intelligence 

• Monitor industry trends in ABA reimbursement, payor policies, and competitive positioning  

• Provide insights to leadership 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 to rate improvements or strengthened payor relationships  

• Payor satisfaction / relationship health (qualitative + survey-based) 

Qualifications Required 

• 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-level communication and presentation skills 

• Negotiation and influencing skills 

• Data storytelling and visualization 

• Strategic thinking with strong business acumen 

• Relationship management and stakeholder engagement 

• Problem-solving and cross-functional collaboration 

Why Behavior Frontiers is perfect for you: 

• Competitive pay with optional On-demand paychecks thru DailyPay - 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 promotion raises 

• 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 to some support services (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% at 60,000+ locations nationwide 

Why 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.