Director of Payer Relations

Director of Payer Relations, Blue Balloon ABA

Job Summary

We are seeking a Director of Payer Relations for Blue Balloon ABA. In this role, you will have responsibility to establish, nurture, and grow strategic relationships with payers, Medicaid agencies, and care management organizations. You will coordinate with some of our most important partners to provide updates on patient progress and outcomes, opening referral pathways, and working to resolve issues including (not limited to) authorizations, credentialing, and billing.

The ideal candidate combines deep ABA experience with understanding of payer dynamics and incentives, and excellent communication and stakeholder management skills.

Key Responsibilities

1. Ongoing payer relations:

• Schedule and lead regular update calls with priority payers and community partners, providing updates on kiddo progress, outcomes data, and other business developments.
• Understand payer priorities and needs; drive agenda, prepare appropriate materials and messaging, and ensure the correct experts are on call to speak to payer questions.
• Build and maintain ongoing payer relationships and convey the value and impact of Blue Balloon ABA.
• Utilize relationships to help other departments and further business objectives—increasing referrals, accelerating authorizations, and addressing denials or billing timeliness.
• Facilitate and support payer visits to Blue Balloon sites as relevant.

• Build on relationships to understand how to better align our model to the incentives and needs of payers.
• Provide insights to clinical leaders, contracting, and overall management to shape creative arrangements that better serve the needs of patients, payers, and Blue Balloon ABA.

• Work closely with clinical and finance leaders to improve automation of reporting to ensure efficient workflows for regular payer updates.

Qualifications

• 5+ years experience in ABA either in Payer Relations, Contracting, or Clinical Leadership capacity.
• Track record of leadership and innovation.
• Deep knowledge of outcomes data, payer incentives, and ABA processes and systems.
• Detail oriented, strong organizational, time management, analytical, problem-solving skills.
• Exceptional verbal, written, and interpersonal communication skills.
• Demonstrated commitment to cultivating a neurodiversity-affirming culture.
• A passion for working with children with Autism Spectrum Disorder and their families.

What We Offer

• A competitive salary with bonuses and comprehensive benefits, tailored to recognize the expertise and contributions you bring to the role.
• An exceptional leadership platform to influence and guide industry-leading clinical care while playing a key role in driving growth.
• A meaningful opportunity to make a difference in the lives of thousands of children with Autism Spectrum Disorder and their families.

Location

Remote; location near New Jersey or Maryland preferred. Must be able to travel and spend time in the states we operate (or will operate) as well as attend industry events. We provide the flexibility to work from home or other locations when the responsibilities allow.

To apply

Please email a resume and brief cover letter to