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 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 health care value.
- Reviews and assesses the needs of Alliance employers and develops and implements strategic contracting plans to fulfill network initiatives.
- Gathers current market intelligence and information through a community, employer, broker, and provider relationships, then recommend and assist in the 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 bachelors degree in business or related field (or equivalent experience) and a minimum of five years of experience in provider relations and contracting in health care or health insurance.
Celebrating 25+ years as a not-for-profit, employer-owned cooperative, The Alliance exists to help our members manage their health care costs, improve quality and engage individuals in their health. We serve more than 240 employers in Wisconsin, Illinois and Iowa and contract with more than 18,000 health care providers and specialists across that region. We provide information and resources to help members make health care purchases based on value and create healthier workforces.
In this role you’ll be backed by a strong business development, member services, marketing, customer service, technology and administrative teams. You’ll be part of an organization with high levels of employee engagement. The Alliance is mission-driven, member-centered, respectful, and supportive of team members.
Interested candidates can apply here.