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 Network Development 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 negotiating 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 recommend and assist 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 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 degree in business or related field (or equivalent experience) and a minimum of five years of experience in provider relations and contracting. in healthcare or health insurance. Currently this position works remote and post-pandemic the position can continue to work remote a large majority of the time.
The Alliance serves as the voice for self-funded employers who are tired of traditional health care and want more control over their costs. We provide transparent, creative approaches to network and benefit plan design to unlock savings where others can’t – or won’t – using Smarter Networks(SM) and sophisticated data mining and analysis. 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 work with more than 275 employers across the Midwest and contract with over 34,000 health care providers and specialists in the region. Our goal is to help employers better manage their healthcare costs while emphasizing value and creating healthier, more engaged workforces.
The Alliance is celebrating 30 years as a mission-driven and member-focused collective with strong and proven sales, member services, marketing, customer service, network development, technology and administrative teams. By joining The Alliance, you’ll be part of a passionate, collaborative, and supportive organization with high levels of employee engagement and satisfaction.
The Alliance is in a modern facility in a new section of the Fitchburg Technology Campus located on the south side of Madison. The organization is friendly and informal yet professional. A competitive compensation and benefits package is provided, including health/dental/vision/life insurances, Staff Incentive Bonus program, 401(k) and annual Continuing Education and Wellness benefits.
The Alliance is unable to provide sponsorship for a H1-B work visa at this time.
Equal Opportunity Employer.