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Job Details
The Senior Director of Payor Contracting, Practice Integration & Transition Support leads all payor-facing contracting activity for newly acquired or affiliated practices, ensuring each practice is fully in-network and reimbursed without disruption from day one. This role owns payor negotiation during the critical first 90-180 days after close, while managing the broader operational handoffs needed to fold a new practice into the organization's managed care infrastructure.
This is a hybrid strategic-operational role: part payor negotiator, part project manager, part relationship lead.
Primary Responsibilities
Payor Contracting & Negotiation
- Determine the appropriate enterprise contracting strategy for each new practice - tuck-in (rolled into an existing pillar contract), pillar (maintained as a standalone anchor agreement), or de novo (newly negotiated from scratch) - based on markets, payor mix, and existing network agreements
- Lead negotiation of new and amended payor agreements (commercial, Medicare Advantage, Medicaid MCO) for newly acquired practices, targeting favorable reimbursement rates and terms
- Analyze existing fee schedules and reimbursement terms at acquired practices to identify rate gaps, renegotiation opportunities, and risk exposure before and after close
- Maintain a payor contract library and tracking system for effective dates, renewal terms, fee schedules, and termination/renegotiation clauses across all practices
- Partner with inside and outside counsel on contract language, risk terms, and reimbursement modeling
Contracting Data Management & Communication
- Responsible for initial build and vetting of payor contracting profiles against pre-close inventory; serves as main point of contact for RCA teams on said profiles
- Builds out project plan and trackers to monitor and execute diligence and related timelines
- Ensures current fee schedules are accessible to RCA teams to promote rate visibility and compliance
Transition & Integration Support
- Own the payor-related workstream of the integration playbook: pre-close contract assessment, day-one network readiness, and post-close rate reconciliation
- Serve as the primary point of contact between the new practice and internal teams (revenue cycle, finance, IT) on all payor-related matters
- Drive cross-departmental collaboration and execution with RCM and Operations to ensure timely credentialing and uninterrupted patient access during the transition
- Build and manage payor contracting timelines, identifying risks and dependencies before they become blockers
- Lead onboarding conversations with practice owners and billing staff to explain new payor relationships, fee schedules, and claims submission processes
- Track integration milestones and report payor readiness status to leadership, flagging issues early
Relationship Management
- Serve as a trusted advisor to newly acquired practice owners on payor strategy during a period of significant change
- Maintain and grow relationships with key payor representatives to support faster contracting and issue resolution
- Build repeatable frameworks, templates, and checklists that make each subsequent practice's payor contracting faster and more consistent
Team Support
- Supports training of new team member as needed
- Works collaboratively with Payor team to evaluate, refine, and track return on investment of internal workflows, external/vendor relationships, etc.
- Helps support ad-hoc payor projects as needed
- Required Travel - Up to 20%
Education and Work Experience
- Bachelor's degree required
- 5+ years of experience in payor contracting, managed care, or provider network management
- Direct experience negotiating commercial, Medicare Advantage, and/or Medicaid MCO contracts
- Prior experience supporting multi-site healthcare practice acquisitions strongly preferred
- Strong contract negotiation and fee schedule analysis skills
Skills and Knowledge
- Demonstrated project management ability across cross-functional teams
- Excellent interpersonal skills; able to build trust quickly with new partners under stressful conditions and help them adapt to change
- Familiarity with healthcare regulatory frameworks (Stark Law, Anti-Kickback Statute, corporate practice of medicine) a plus
- Comfortable with ambiguity and fast-changing priorities typical of a growth-stage or acquisitive organization
- Ability to communicate effectively both orally and in writing.
- Strong interpersonal skills.
- Strong leadership and presentation skills.
- Strong organizational skills with attention to detail.
- Knowledge of data analysis and data mining tools, including data warehouses and Microsoft Excel.
What Success Looks Like
- Accurate and complete payor contracting inventories; effective payor contracting transition; strong working relationships with internal and external stakeholders
- Ongoing risk assessment with clear communication to RCA leadership and related stakeholders
- New practices are fully contracted and in-network with all relevant payors within target timelines
- Minimal claims or revenue disruption during expected payor transitions
- A continuously improving, well-documented payor contracting project plan and playbook
What Cencora offers
We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora
Full time
Equal Employment Opportunity
Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.
The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.
Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned
Affiliated Companies
Affiliated Companies: AmerisourceBergen Services Corporation