Sr. Director, Provider Partnerships

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 180,000 - 240,000; Full time

Job summary

Blue Shield of California seeks a Sr. Director, Provider Partnerships to lead strategic provider engagement and partnerships.

You will align multiple internal functions, translate strategies into actionable provider initiatives, and drive outcomes across affordability, quality, access, and member experience. In this role, you will develop leaders, manage complex relationships, and operate in a matrixed organization with a strong focus on the quadruple aim.

Qualifications

• Requires a Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires 12 years of prior relevant experience
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Requires deep expertise in complex provider models, contract structures, and market-specific financial responsibility frameworks (e.g., California delegated models)
• Requires strong experience and orientation to the quadruple aim coupled with knowledge of markets, health plan operations, product development, network management, clinical operations, finance, regulatory issues, and compliance in the healthcare industry
• Requires proven executive provider engagement experience and the ability to manage multiple complex provider relationships at a time, and experience applying industry methodologies and practices
• Requires demonstrated execution orientation with measurable outcomes and accountability
• Requires demonstrated ability to mentor and coach, lead through large-scale change, collaborate and build trusting relationships with provider partners and key internal stakeholders
• Requires strong leadership skills including excellent interpersonal, communications, problem solving and negotiating skills, the ability to think strategically while at the same time drive operational performance, and the ability to effectively work cross-functionally and collaboratively across BSC at all levels of the organization
• Requires technological and data savvy and the ability to utilize information systems effectively
• Knowledge of healthcare utilization metrics is strongly preferred

Responsibilities

• Lead provider partnerships and translate strategies into actionable initiatives that improve affordability, quality, access, and member experience.
• Align across a highly matrixed environment to execute provider engagement plans with enterprise and local market priorities.
• Mentor and develop leaders, drive large-scale change, and foster cross-functional collaboration across BSC.
• Navigate complex provider models and contract structures within California delegated models and other market frameworks.

Skills

Executive leadership

Strategic planning

Provider engagement

Stakeholder collaboration

Change management

Interpersonal communication

Negotiation

Data-driven decision making

Education

Bachelor's degree or equivalent

Job description

Your Role

The Provider Partnerships team is responsible for creating high integrity relationships with medical providers to enable Blue Shield of California (BSC) to be the health plan of choice. The Sr. Director, Provider Partnerships will report to the Vice President Network Strategy in the Network Management and Provider Partnerships department.

In this role you will provide strategic leadership across a highly matrixed environment, aligning multiple internal business functions, and partnering around shared priorities and measurable outcomes. You will effectively execute the provider engagement plans in alignment with enterprise and local market regional priorities for health systems and IPA/Medical Groups for all lines of business. This role serves as a critical connector between BSC and its provider network, translating organization strategies into actionable provider initiatives that advance affordability, quality, clinical performance, access, growth, and overall provider and member experience, across all lines of business.

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.

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


• Requires 12 years of prior relevant experience


• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports


• Requires deep expertise in complex provider models, contract structures, and market-specific financial responsibility frameworks (e.g., California delegated models)


• Requires strong experience and orientation to the quadruple aim coupled with knowledge of markets, health plan operations, product development, network management, clinical operations, finance, regulatory issues, and compliance in the healthcare industry


• Requires proven executive provider engagement experience and the ability to manage multiple complex provider relationships at a time, and experience applying industry methodologies and practices


• Requires demonstrated execution orientation with measurable outcomes and accountability


• Requires demonstrated ability to mentor and coach, lead through large-scale change, collaborate and build trusting relationships with provider partners and key internal stakeholders


• Requires strong leadership skills including excellent interpersonal, communications, problem solving and negotiating skills, the ability to think strategically while at the same time drive operational performance, and the ability to effectively work cross-functionally and collaboratively across BSC at all levels of the organization


• Requires technological and data savvy and the ability to utilize information systems effectively


• Knowledge of healthcare utilization metrics is strongly preferred

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.