About The Position

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.

Requirements

  • 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).

Nice To Haves

  • 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.

Responsibilities

  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
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