Manager, Healthcare Contracts

🕒 Julho 23

⚔️ Virginia – Remoto

⚔️ Virginia – Remote

💵 $83.000 - $124.500 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 4%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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OrthoVirginia

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

🧘 Bem-estar

⚽ Esportes

Healthcare • Wellness • Sports

A OrthoVirginia é uma clínica ortopédica com várias unidades na Virgínia que oferece cuidado abrangente do sistema musculoesquelético, incluindo cirurgia ortopédica, substituição de articulações em regime ambulatorial, medicina esportiva, fisioterapia, atendimento de urgência para lesões ortopédicas, imagem e telemedicina. Com mais de 160 médicos em 38 locais, a OrthoVirginia oferece serviços integrados como terapia no local, centros de cirurgia ambulatorial, atendimento de urgência ortopédico, portais de pacientes (MyChart) e parcerias comunitárias de medicina esportiva para apoiar a recuperação e estilos de vida ativos.

Descrição

• 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.

🎯 Requisitos

• 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.

🏖️ Benefícios

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements