Contract Manager

Alliant Health Group is a family of companies that provides professional services supporting the effective administration of healthcare programs and funding to support healthcare improvement initiatives. Alliant Health Solutions provides Federal and state government entities with the services, expertise and information systems necessary to increase the effectiveness, accessibility and value of health care.

Currently, Alliant Health Solutions, a "2024 Best Place to Work and Healthiest Employer", seeks a Contract Manager. This role is contingent upon award of contract. The Contract Manager is responsible for overseeing the Medicaid Managed Care External Quality Review Provider Network Adequacy Audit Program. The Contract Manager serves as the primary liaison between the customer and Alliant and oversees program operations, supervision of staff, and efficient and effective execution of program activities. This role involves strategic planning, implementation, and evaluation of audit processes to ensure compliance with regulatory standards and the adequacy of the provider network.

In this role, the ideal candidate will:

• Program Leadership: Lead the design, implementation, and management of the External Quality Review Provider Network Adequacy Audit Program.
• Relationship Management: Serve as the initial point of contact for customer inquiries and issues, responding professionally and empathetically. Identify and resolve customer concerns, ensuring their satisfaction and exceeding expectations.
• Regulatory Compliance: Ensure that audit processes align with federal and state regulations, and industry best practices.
• Data Analysis: Analyze data related to provider network adequacy, identifying trends and areas for improvement.
• Collaboration: Work closely with Medicaid managed care organizations, providers, and stakeholders to enhance the quality and accessibility of care.
• Quality Improvement: Develop and implement strategies for continuous quality improvement in provider network adequacy.
• Training and Development: Provide training and guidance to audit staff and stakeholders on audit methodologies and compliance requirements.
• Reporting: Prepare and present audit findings and recommendations to senior management, customers, stakeholders and relevant regulatory bodies.
• Budget Management: Oversee the budget for the audit program, ensuring resources are allocated efficiently.

• Build awareness of other customer programs to understand the external quality review operating environment and identify upcoming changes that could impact the existing work with the customer or possible new opportunities for the company.
• Work in close collaboration with other team members to support the development of new projects and the continuous improvement of the overall work of the team.
• Promote core values of teamwork, professionalism, effective communication skills and positive behaviors.
• Maintain security and confidentiality of all information in accordance with HIPAA laws and regulations and company policies.
• Demonstrate compliance with company and departmental policies as evidenced by attendance, punctuality, and dress.
• Perform other duties as assigned.

• Computer literate; proficient in Microsoft Office applications, Customer Relationship Management (CRM) proficiency
• Skilled in using analytic reports and data as part of ongoing service delivery and operations management
• Ability to travel by car or plane to Company locations, customer meetings or other locations as needed
• Advance knowledge of Medicaid policies and regulations
• Excellent analytical and problem-solving skills
• Proven ability to manage projects and lead teams effectively
• Strong communication and interpersonal skills

Education, experience and training required and preferred for the position are below:

Required:

• Bachelor's degree in healthcare administration, public health or a related field
• Minimum of 5 years of experience in managed care, quality assurance or healthcare auditing

• Master's degree in a related field
• Certification in healthcare quality or auditing (e.g., CPHQ, CQA)
• Experience with data analysis tools and software
• Familiarity with healthcare quality improvement frameworks

Alliant offers work/life balance and great benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental life, and more. If interested, click the apply icon above to apply.
If you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact 678-527-3000.