Senior Director of Network Strategy

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.

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

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.