Director, Payor Relations & Credentialing

Metro Vein Centers
Oakland County, Michigan
Full time
1 day ago

Director, Payor Relations & Credentialing

Metro Vein Centers
Remote or Hybrid (Detroit or NYC)

Healthy legs feel better.

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. Our industry-leading team of board-certified physicians is on a mission to meaningfully improve people’s quality of life by relieving the often painful and highly treatable symptoms of vein disease—such as varicose veins and heavy, aching, swollen legs. We currently operate 60+ clinics throughout 7 states with a vision of becoming the go-to vein care choice for patients nationwide.

How You’ll Make a Difference:

You'll be the strategic force behind our financial health and growth. As the Director of Payor Relations & Credentialing, reporting to the Chief Revenue Officer, you will manage our payor relationships, optimize our payor contracts to maximize reimbursement, and ensure our providers are seamlessly credentialed. Your leadership will directly enable our expansion and ensure our patients can get the care they need without hassle.

This position will partner closely with Revenue Cycle Management (RCM), patient intake, and clinical operations to ensure patients can be scheduled easily and seen promptly, regardless of insurance. You will lead the credentialing team—currently one supervisor and two specialists—while also building scalable tools and processes for future growth.

Key Responsibilities:

  • Identify and evaluate payer relationships, pursuing new contracting opportunities while assessing underperforming payers for termination, and negotiating agreements to maximize reimbursement rates and favorable terms.
  • Establish and manage a comprehensive contract repository to support payer relations, incorporating processes for document storage, tracking, and lifecycle management.
  • Evaluate and refine carrier code structures to maintain accurate mapping of revenues to contractual terms and reimbursement methodologies.
  • Develop and maintain relationships with payer representatives to strengthen partnerships to resolve revenue cycle, clinical, compliance, and operational issues.
  • Direct the credentialing function, overseeing a supervisor and two specialists, to drive efficient provider enrollments, on-time revalidations, and prompt resolution of credentialing issues impacting reimbursement.
  • Collaborate with Patient Intake to ensure accurate identification of insurance plans participating with our providers, reducing scheduling errors and enhancing patient experience.
  • Collaborate with Business Development to create standardized processes that accelerate and optimize new provider, clinic, and market activations.
  • Develop dashboards and reports for leadership on payer performance, credentialing metrics, and contract opportunities.
  • Stay current on payer policy changes, credentialing requirements, and healthcare market trends.

Competencies:

  • Payor Contracting & Negotiation Expertise
  • Credentialing Operations Leadership
  • Analytical & Strategic Thinking
  • Cross-Functional Collaboration
  • Change Management
  • Data-Driven Decision Making
  • Communication and Influence

Required Education and Experience:

  • Bachelor’s degree in business, healthcare administration, or related field (or equivalent experience)
  • 7+ years of experience in payer contracting, provider relations, and/or credentialing within a multi-site healthcare organization
  • 3+ years of leadership experience managing payer relationships and/or credentialing teams
  • Proven success in reimbursement rate negotiations and payer performance improvement initiatives
  • Strong understanding of payer policies, credentialing regulations, and healthcare compliance requirements

Preferred Education and Experience:

  • Experience in outpatient or specialty care settings
  • Experience with Athena EMR
  • Prior experience in a growing multi-site healthcare organization
  • Experience implementing credentialing or contract management software
  • Familiarity with vein care, vascular specialties, or specialty outpatient care settings

Benefits to Fit Your Lifestyle
At Metro Vein Centers, we’re committed to supporting your well-being—inside and outside of work. Our benefits package is designed to provide flexibility, peace of mind, and support for your health, financial future, and work-life balance.

Here’s what we offer:

  • Medical, Vision, and Dental Insurance: Comprehensive coverage through Blue Cross Blue Shield (medical/vision) and Humana (dental) for you and your dependents.
  • 401(k) Retirement Plan: 4% employer match.
  • Paid Time Off (PTO): Flexible PTO policy for full-time and part-time employees, with accruals increasing over time. 7 paid holidays plus a floating holiday.
  • Health Savings Account (HSA): Save pre-tax dollars for medical expenses via HealthEquity.
  • Flexible Spending Accounts (FSA): Options for healthcare and dependent care expenses, available pre-tax.
  • Life & Disability Coverage: $25,000 in company-paid basic life insurance, with optional coverage for life, AD&D, and short-term disability.

Voluntary Benefits

  • Including accident insurance, critical illness coverage, and more—employee-paid and customizable.
  • Employee Assistance Program (EAP): Free, confidential support for counseling, legal guidance, financial wellness, and more.
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