At OrthoVirginia, you’re part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia’s largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment.
With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive.
Join us and become part of a trusted network committed to excellence in orthopedic care.
Key Responsibilities
Contract Development & Negotiation
- Develop, negotiate, and maintain contracts with all payer types, including insurance companies, MSOs, IPAs, TPAs, and government programs.
- Research territories to identify gaps in payer coverage and support expansion into new markets.
- Ensure all contractual arrangements meet financial targets and comply with legal and regulatory requirements.
- Analyze cost, utilization, and reimbursement data to support negotiation strategy and decision-making.
Contract Lifecycle Management
- Lead the full contract process from pre‑contract planning through post‑signature implementation.
- Facilitate internal approval processes for all contract documents.
- Ensure accuracy and completeness of all supporting documentation.
- Develop and maintain systems to track critical contract events such as renewals, terminations, and key deadlines.
Relationship Management
- Maintain strong relationships with contracted providers and payer partners.
- Review and update contractual language to ensure accuracy and relevance.
- Evaluate fee schedules annually to identify opportunities for expanded services, reimbursement adjustments, and policy updates.
Internal Collaboration & Communication
- Work closely with leadership to support strategic business goals and organizational growth initiatives.
- Communicate contract terms, updates, and policy changes to internal departments, especially billing and revenue cycle teams.
- Ensure staff are informed of payer medical policy changes, billing requirements, and reimbursement updates.
Reporting & Data Management
- Conduct ongoing assessments of assigned networks and recommend strategic initiatives.
- Prepare bi‑weekly status reports on all contracts and contracting activities.
- Ensure accurate data entry of contract terms and specifications into internal databases.
- Support contracting administration and special projects as needed.
Qualifications & Experience
Required:
- Minimum 3 years of experience in healthcare contracting with hospitals, clinics, physician groups, primary care networks, or health systems.
- Bachelor’s degree required.
- Strong understanding of healthcare industry operations, payer structures, and regulatory requirements.
- Proven contract negotiation skills and experience managing payer relationships.
- Excellent written and verbal communication skills.
- Ability to work independently, take initiative, and manage multiple priorities in a fast‑paced environment.
- Strong organizational, analytical, and problem‑solving skills.
- Proficiency with MS Office Suite, PowerPoint, and internet-based research tools.
- Experience with Epic software (required).
- Experience working for a medical insurance company, MSO, IPA, or TPA.
- Demonstrated ability to develop and deliver presentations to internal and external stakeholders.
- Strong interpersonal skills and a track record of building effective provider partnerships.
This organization participates in e-Verify. Esta organización participa en e-Verify.