Top 121 Pre certification specialist Jobs in Richmond Va

Manager, Healthcare Contracts
OrthoVirginia Inc —Richmond, VA
- $83,000 - $124,500 a year
- Full-time
- Research
- 3 years
- Bachelor's degree
Quick Apply
4d
Scheduling Specialist - Tuckahoe Orthopaedic & Physical Therapy
Bon Secours —Richmond, VA
- $17.25 - $25.87 an hour
- Mid-level
- High school diploma or GED
- Children
- Health savings account
- Disability insurance
Scheduling Specialist - Tuckahoe Orthopedics
Bon Secours —Henrico, VA
- $17.25 - $25.87 an hour
- Hospital
- Mid-level
- High school diploma or GED
- Health savings account
- Disability insurance
Clinical Team Member, Part Time
OrthoVirginia Inc —Richmond, VA
- $17.98 - $26.97 an hour
- Part-time
- Vital signs
- Computer literacy
- Outpatient experience
Quick Apply
Surgery Scheduler
Virginia Urology / Med Atlantic Inc —Richmond, VA
- $17.88 - $24.59 an hour
- Full-time
- Surgery
- Ability to walk for extended periods
- Medical office experience
- Health insurance
- Paid time off
Quick Apply
13d
Patient Access Associate Specialist
Ensemble RCM LLC —Chester, VA
- $17.00 - $18.15 an hour
- Part-time
- Customer service
- High school diploma or GED
- ER
- Tuition reimbursement
6d
Clinical Team Member
OrthoVirginia Inc —Midlothian, VA
- $17.98 - $26.97 an hour
- Part-time
- Vital signs
- Clinic
- Perioperative Care
Quick Apply
Human Resources Specialist
Virginia Eye Institute —Richmond, VA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Clinical Team Member, Part-Time
OrthoVirginia Inc —Midlothian, VA
- $17.98 - $26.97 an hour
- Part-time
- Vital signs
- Computer literacy
- Outpatient experience
Quick Apply
Patient Access Specialist Associate
Ensemble RCM LLC —Richmond, VA
- $17.00 - $18.15 an hour
- Full-time
- Hospital
- Customer service
- High school diploma or GED
- Tuition reimbursement
Administrative Services Specialist
US Executive Office for U.S. Attorneys and the Office of the U.S. Attorneys —Richmond, VA
- $52,710 - $68,524 a year
- Part-time
- Background check
- Customer service
- Writing skills
- Paid holidays
- Life insurance
2d
Benefit Programs Specialist
Chesterfield County, VA —Chesterfield, VA
- $53,309 - $62,638 a year
- Full-time
- Spanish
- Writing skills
- Basic math
- Loan forgiveness
11h
Office Specialist
Appomattox Imaging —Colonial Heights, VA
- $16.02 - $22.43 an hour
- Full-time
- Organizational skills
- 1 year
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Medical Assistant, Full-Time
OrthoVirginia Inc —Midlothian, VA
- $17.98 - $26.97 an hour
- Full-time
- Vital signs
- Clinic
- Perioperative Care
Quick Apply
Watchman Therapy Awareness Representative - Richmond/Roanoke, VA
Boston Scientific —Richmond, VA
- $112,000 a year
- Full-time
- Hospital
- Customer service
- Pass drug screening
Radiology Technologist (RT) - Orthopedic Specialists of Midlothian
Bon Secours —Midlothian, VA
- $26.82 - $41.57 an hour
- Surgery
- BLS Certification
- Mid-level
- Health savings account
- Disability insurance
Construction Project Manager
Canyon Contracting —Highland Springs, VA
- $100,000 - $150,000 a year
- Full-time
- Construction site
- 5 years
- Driver's License
- Profit sharing
- Health savings account
Quick Apply
14d
Construction Project Manager
Canyon Contracting —Glen Allen, VA
- $100,000 - $150,000 a year
- Full-time
- Construction site
- 5 years
- Driver's License
- Profit sharing
- Health savings account
Quick Apply
14d
Language Fundamentals Teacher
The New Community School —Richmond, VA
- Email
- Background check
- School experience
- Classroom
- Health insurance
- Dental insurance
Quick Apply
HVAC/R Service Technician - Light Commercial
CoolSys —Richmond, VA
- $29 - $52 an hour
- Full-time
- Background check
- Clean driving record
- Construction site
- Paid training
- Paid holidays

I want to receive the latest job alert for pre certification specialist in richmond va

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

pre certification specialist jobs near richmond va

Manager, Healthcare Contracts

OrthoVirginia Inc -
Richmond, VA

Quick Apply

Job Details

Full-time
$83,000 - $124,500 a year
4 days ago

Qualifications

Medical software
Presentations for conferences or internal meetings
Research
Client relationship development
Contract management experience in healthcare
Bachelor's degree
Health insurance knowledge
Productivity software
Terms and conditions negotiation
Analytics

Full Job Description

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.

IND123

Compensation Range for this position:

$83,000.00 - $124,500.00

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.

Quick Apply

Refine Your Search

pre certification specialist jobs in richmond va

Manager, Healthcare Contracts

Scheduling Specialist - Tuckahoe Orthopaedic & Physical Therapy

Scheduling Specialist - Tuckahoe Orthopedics

Clinical Team Member, Part Time

Surgery Scheduler

Patient Access Associate Specialist

Clinical Team Member

Human Resources Specialist

Clinical Team Member, Part-Time

Patient Access Specialist Associate

Administrative Services Specialist

Benefit Programs Specialist

Office Specialist

Medical Assistant, Full-Time

Watchman Therapy Awareness Representative - Richmond/Roanoke, VA

Radiology Technologist (RT) - Orthopedic Specialists of Midlothian

Construction Project Manager

Construction Project Manager

Language Fundamentals Teacher

HVAC/R Service Technician - Light Commercial

I want to receive the latest job alert for pre certification specialist in richmond va

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected