Manager, Healthcare Contracts

🕒 vor 15 Tagen

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $83.000 - $124.500 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

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OrthoVirginia

WebsiteLinkedInAlle Stellen

1001 - 5000 Mitarbeiter

🏥 Gesundheitswesen

🧘 Wellness

⚽ Sport

Healthcare • Wellness • Sports

OrthoVirginia ist eine orthopädische Praxis an mehreren Standorten in Virginia, die umfassende muskuloskelettale Versorgung bietet, darunter orthopädische Chirurgie, ambulante Gelenkersatzverfahren, Sportmedizin, Physiotherapie, Notfallversorgung bei orthopädischen Verletzungen, Bildgebung und Telemedizin. Mit mehr als 160 Ärzten an 38 Standorten bietet OrthoVirginia integrierte Dienstleistungen wie Vor-Ort-Therapie, ambulante Operationszentren, orthopädische Notfallversorgung, Patientenportale (MyChart) und Community-Partnerschaften in der Sportmedizin zur Unterstützung der Genesung und eines aktiven Lebensstils.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

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