Manager, Healthcare Contracts

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.

The Healthcare Contracts Manager is responsible for leading the development, negotiation, implementation, and ongoing management of all healthcare payer contracts. This critical role supports organizational growth by securing new payer agreements, strengthening existing partnerships, and ensuring contract terms align with financial objectives, operational priorities, and regulatory requirements.

The ideal candidate is highly detail-oriented, analytical, and proactive, with a proven ability to thrive in a fast-paced environment. They excel at building and maintaining strong relationships with payers, providers, and cross-functional internal stakeholders. Serving as a key contributor to the organization's success, this hands-on role manages the full contract lifecycle, from strategic pre-contract planning and negotiation through execution, implementation, and post-signature oversight.

Remote, Must be in Virginia

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.

Compensation for this role will be based on several factors, including the candidate's qualifications, relevant experience, education, skills, certifications, geography/market, and internal equity considerations.

This organization participates in e-Verify. Esta organización participa en e-Verify.

Originally posted on Himalayas