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
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Develop, negotiate, and maintain contracts with all payer types, including insurance companies, MSOs, IPAs, TPAs, and government programs.
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Research territories to identify gaps in payer coverage and support expansion into new markets.
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Ensure all contractual arrangements meet financial targets and comply with legal and regulatory requirements.
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Analyze cost, utilization, and reimbursement data to support negotiation strategy and decision-making.
Contract Lifecycle Management
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Lead the full contract process from pre‑contract planning through post‑signature implementation.
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Facilitate internal approval processes for all contract documents.
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Ensure accuracy and completeness of all supporting documentation.
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Develop and maintain systems to track critical contract events such as renewals, terminations, and key deadlines.
Relationship Management
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Maintain strong relationships with contracted providers and payer partners.
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Review and update contractual language to ensure accuracy and relevance.
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Evaluate fee schedules annually to identify opportunities for expanded services, reimbursement adjustments, and policy updates.
Internal Collaboration & Communication
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Work closely with leadership to support strategic business goals and organizational growth initiatives.
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Communicate contract terms, updates, and policy changes to internal departments, especially billing and revenue cycle teams.
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Ensure staff are informed of payer medical policy changes, billing requirements, and reimbursement updates.
Reporting & Data Management
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Conduct ongoing assessments of assigned networks and recommend strategic initiatives.
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Prepare bi‑weekly status reports on all contracts and contracting activities.
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Ensure accurate data entry of contract terms and specifications into internal databases.
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Support contracting administration and special projects as needed.
Qualifications & Experience
Required:
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Minimum 3 years of experience in healthcare contracting with hospitals, clinics, physician groups, primary care networks, or health systems.
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Bachelor’s degree required.
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Strong understanding of healthcare industry operations, payer structures, and regulatory requirements.
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Proven contract negotiation skills and experience managing payer relationships.
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Excellent written and verbal communication skills.
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Ability to work independently, take initiative, and manage multiple priorities in a fast‑paced environment.
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Strong organizational, analytical, and problem‑solving skills.
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Proficiency with MS Office Suite, PowerPoint, and internet-based research tools.
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Experience with Epic software (required).
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Experience working for a medical insurance company, MSO, IPA, or TPA.
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Demonstrated ability to develop and deliver presentations to internal and external stakeholders.
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Strong interpersonal skills and a track record of building effective provider partnerships.
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