Within the biopharma industry there is a growing emphasis on alliances and collaboration with external organizations driven by the need to access innovation, fill product pipelines, and de-risk development. While alliances are not new to industry, increased interdependency, complexity and competition between pharma, biotech, diagnostic, CRO, venture capital, government, and academic partners, present unfamiliar challenges for forging alliances and creating operational harmony. Alliance managers operate as central drivers of value generation between partnering organizations; alleviating perturbations, while striving to meet alliance goals. Each partnership is unique, but managers need proven tools, methods and leadership skills to create a successful, harmonious relationship between organizations.