Be An Important Part of The Alliance’s Mission!
The Alliance moves health care forward by controlling costs, improving quality, and engaging individuals in their health. As a not-for-profit, employer-owned cooperative, we exist to help our members manage their health care dollars while positively impacting their employees’ health.
Put your contracting expertise and relationship-building skills to best use in this key role which supports and enhances The Alliance’s provider network. This position takes a lead role in the development and maintenance of The Alliance’s provider network in designated markets. The Provider Contracting & Relations Manager conducts visits with prospective and existing providers, negotiates provider contracts, and maintains mutually beneficial relationships with providers.
1. Provider Contracting and Relationship Building
- Manages existing relationships and strategically recruits and contracts with prospective providers (such as health systems, ambulatory surgical centers, and ancillary providers) to ensure the network meets the needs of current and future members while assuring member access and value.
- Secures reimbursement rates that are competitive and current with Medicare and other payer reimbursement trends.
- Evaluates contract performance continuously and renegotiates contracts, ensuring that language and reimbursement terms meet goals and objectives.
- Maintains and builds effective provider partnerships by serving as the primary point of contact for providers and for contract interpretation and administration.
- Manages and negotiates complex multifaceted contracts including language and reimbursement modifications
2. Strategic Initiatives
- Keeps abreast of industry initiatives including reimbursement, coding, and contracting trends relative to providers and recommends tactics that advance The Alliance’s mission of improving healthcare value.
- Reviews and assesses Alliance employer’s needs, and develops and implements strategic contracting plans to fulfill network initiatives.
- Gathers current market intelligence and information through community, employer, broker and provider relationships, then recommends changes and assists in implementation of initiatives to improve The Alliance’s value proposition.
3. Coordination with Business Development
- Works collaboratively with Business Development to grow and maintain The Alliance membership.
- Attends employer presentations and may present at such sessions in coordination with Business Development staff.
4. Manages projects related to Network Development initiatives, ensuring project goals and timelines are met or exceeded.
In addition to excellent contracting, relationship-building, communication, analysis, and strategic project management skills, the ideal candidate will have a bachelor’s degree in business or related field (or equivalent experience) and a minimum of five years’ experience in provider relations and contracting, healthcare, or health insurance. We offer flexible scheduling, including working 4 ½ days/week during the summer. Additionally, post-training, this position will mostly work remote – if desired – but you may be required to attend in-person meetings with teammates or healthcare providers a few times per month.
As a not-for-profit cooperative, The Alliance is employer-owned and remains a trusted, objective partner for employers and their brokers who seek improved access to high-quality healthcare.
We’re Madison-based, but we work with 300+ employers across the Midwest and contract with over 34,000 doctors and other health care providers in the region. Our goal is to help employers better manage their healthcare costs while remaining transparent and emphasizing value – creating healthier, more engaged workforces.
The Alliance is celebrating over 30 years as a mission-driven and member-focused collective with experienced leadership and strong organizational departments backed by top talent. By joining The Alliance, you’ll become part of a passionate, collaborative, and supportive organization: one that fosters meaningful connections and relationships with high levels of employee engagement and satisfaction.
Our health plan is self-funded, which means we share the same interests and use the same tools that we offer our clients. We lead by example because when we take care of our employees, they take care of our clients (and their employees.)
We set our employees up for success, encouraging not only their professional advancement but also their personal growth. We offer a competitive compensation and benefits package, including health/dental/vision/life insurances, a generous Staff Incentive Bonus program, 401(k), and annual Continuing Education and Wellness benefits.
To learn more about The Alliance click here.
The Alliance is unable to provide sponsorship for a H1-B work visa at this time.
Equal Opportunity Employer.