Senior Director of Network Strategy

Blue Shield of California; California; Hybrid; USD 213,000 - 319,000; Full time

Job summary

Blue Shield of California is seeking a Sr. Director, Strategic Planning and Performance (Network Strategy) to lead multi-year roadmaps for network design, affordability initiatives, and provider partnerships across California.

The role reports to the VP and acts as business owner for strategic initiatives, collaborating with cross-functional teams to deliver scalable operating models, analytics, and governance that drive value for members and providers.

Qualifications

• Requires a Bachelor's degree or HSD/GED with 4 years of relevant experience; a Master’s degree (MBA or MPH) is preferred.
• Requires 12 years of prior relevant experience with at least 10 years in Provider or Health Plan and experience leading a complex, strategic portfolio of business and IT initiatives; fifteen (15) years of experience is preferred.
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports.
• Deep knowledge of Network Strategy, Contracting, Operations, and Compliance.
• Certifications preferred: Project Management Professional (PMP), Lean Six Sigma, Agile.

Responsibilities

• Partner with the VP, Network Strategy to drive and execute robust strategic roadmaps for each LOB and region.
• Identify and execute on Cost of Health Care (COHC) affordability opportunities.
• Lead team on complex initiatives to deliver COHC savings targets and drive operational excellence.
• Lead Network initiatives under the Affordability Office and serve as primary liaison to Affordability Office.
• Create scalable, structured provider engagement and backend operating model that drives provider performance.
• Collaborate with cross-functional partners to build and deploy an operating model with touchpoints across multiple functions.
• Own the implementation and optimization of a provider CRM platform delivering a unified, enterprise-wide view of interactions.
• Lead the provider analytics strategy supporting network design, performance management, provider selection, and evaluation of strategic partnerships.
• Develop, implement, and manage the Network Governance framework that drives enterprise-wide decision-making and prioritization.
• Drive analytics and process automation to enable scaling from Tier 1 to Tier 2 providers.
• Lead the technology enablement roadmap for Network Strategy.
• Partner with Provider Operations, Provider Transformation, and IT/Stellarus to develop multi-year roadmap.

Skills

Strategic planning

Leadership

Program management

Cross-functional collaboration

Analytics

Education

Bachelor’s degree

Master’s degree preferred

Job description

Your Role

The Network Strategy team is a team of strategists and program managers that are responsible for developing and executing a Blue Shield of California (BSC) Provider Partnerships & Network Management strategy.

Job Description

Your Role

The Network Strategy team is a team of strategists and program managers that are responsible for developing and executing a Blue Shield of California (BSC) Provider Partnerships & Network Management strategy.

The Sr. Director, Strategic Planning and Performance (Network Strategy) will report to the VP, Network Strategy. In this role, you will be responsible for driving and executing a multi-year strategic roadmap for network design and optimization and provider partnerships; partnering closely with line of business (LOB) leaders to establish and execute statewide, regional and LOB-level Network strategic roadmaps. You will function as the Business Owner for strategic and operational initiatives designed to execute on the strategic roadmaps. Additionally, you will be responsible for identifying and executing on opportunities to drive affordability and will serve as the Provider Partnerships & Network Management leadership representative to the Affordability Office.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work

In this role, you will:

• Partner with the VP, Network Strategy to drive and execute on robust strategic roadmaps for each LOB and region, aligning network design, affordability goals, market needs, and product strategies into a cohesive, actionable plan
• Identify and execute on Cost of Health Care (COHC) affordability opportunities
• Lead team on complex initiatives to deliver on COHC savings targets and drive operational excellence
• Lead Network initiatives under the Affordability Office and serve as primary liaison to Affordability Office
• Create scalable, structured provider engagement and backend operating model that drives provider performance and addresses key pain points: Provider Accounts Receivable, Recoupments & Claims Issue Resolution
• Collaborate extensively with cross-functional partners to drive a cross-functional process to build and deploy an operating model with touchpoints across Provider Partnerships, Contracting, Provider Relations, Quality, Claims, Delegation Oversight, Network Operations, Provider Operations, and Regional Medical Directors
• Own the implementation, and optimization of a provider CRM platform delivering a unified, enterprise‑wide, 360° view of BSC interactions with providers
• Lead the provider analytics strategy supporting network design, performance management, provider selection, and evaluation of strategic partnerships
• Develop, implement, and manage the Network Governance framework that drives enterprise‑wide decision‑making, transparency, and prioritization for Network Strategy and critical network decisions
• Drive analytics and process automation to enable scaling from Tier 1 to Tier 2 providers
• Lead the technology enablement roadmap for Network Strategy
• Partner closely with Provider Operations, Provider Transformation, and IT/Stellarus to develop and execute multi-year roadmap that supports stable and efficient operations and delivers key high-value enhancements

Qualifications

Your Knowledge and Experience

• Requires a Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree. A Master’s degree (MBA or MPH) is preferred
• Requires 12 years of prior relevant experience with at least 10 years of Provider or Health Plan experience and experience leading complex, strategic portfolio of business and IT initiatives. Fifteen (15) years of experience is preferred
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Deep knowledge of Network Strategy, Contracting, Operations, and Compliance
• Proven ability to build and lead high-performing teams
• Certifications preferred: Project Management Professional (PMP), Lean Six Sigma, Agile

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Us

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

JOB INFO

Job Identification : 20262103

Job Category : Business Operations

Posting Date : 2026-10-20T00:08:28+00:00

Job Schedule : Full time

Locations :

Long Beach, CA, United States

CA, United States

El Dorado Hills, CA, United States

Lodi, CA, United States

Oakland, CA, United States

Rancho Cordova, CA, United States

Redding, CA, United States

San Diego, CA, United States

Woodland Hills, CA, United States

Pay Range for California : $212630.00 to $318890.00

Pay Range for Bay Area : $239692.00 to $359476.00

Note : Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

Role can be filled by a candidate requiring sponsorship : No