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.
Numbers & Facts
Location
El Segundo, CA
Job Type
Full-time
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