Product Manager

Your Role 

The Partner Services team leads the selection and implementation of new vendor/provider solutions to support the highest cost and prevalence conditions across Blue Shield of California members. The Clinical Product Senior Principal will report to the Senior Director of Clinical Product Strategy and Innovation. In this role you will build and develop the clinical product strategy and roadmap for high-cost conditions, with an initial focus on Oncology.  This role will partner closely with Commercial and Government Markets to design, deliver, and continuously evolve clinical programs that meet the needs of clients, plan sponsors, Covered California, Medi Cal, and CMS. This role supports the clinical product strategy via sustained roadmaps that enable innovative, scalable, and measurable clinical capabilities in service of Blue Shield’s mission to make healthcare affordable, high quality, and accessible for Californians.

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: 

• Strategy & Roadmap: Lead clinical product strategy with LOB, network and clinical leaders with multi-year roadmap aligned to enterprise and market needs. 
• Market Partnership: Partner with Commercial and Government Markets to design compliant, differentiated clinical programs through cross functional coordination. This role also includes working with our hospital partners directly to drive value via our partnership strategy.
• Outcomes Measurement: Define outcomes measurement and reporting across clinical performance, engagement, affordability, and ROI.
•  Vendor Management: Oversee clinical product vendor performance and partnerships, including contracting, performance guarantees, shared risk, and integration. Clinical buy-up offerings
• Drive cross-functional alignment so teams make consistent tradeoffs and deliver measurable results by influencing priorities, resourcing, risk decisions, and performance outcomes across the organization.
• Continuously improve and evolve the clinical product domain.
• Identify gaps/opportunities, design new or improved programs and processes, and scale them with measurable outcomes (quality, affordability, experience, and ROI).
• Act as subject matter expert in assigned clinical products, governance and performance.
• Understand contract negotiation, financing, managed care and provider relationships. 
• Oversee key programs and contracts that impact member pricing, member experience (sales), and cost of healthcare.
• Oversee processes, procedures, and vendor selection which significantly impacts our clinical operations.

Qualifications

Your Knowledge and Experience 

• Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree.
• Advanced degree (e.g., MPH, MBA, MHA) preferred
• 12 years prior relevant experience required
• Expertise in medical management, including utilization management, case management, and population health strategy required
• Proven experience developing and executing multi-year clinical product roadmaps in healthcare or payer environments required
• Requires experience working at a health plan (managed care, government payer, or academic)
• Experience working in oncology is preferred
•  Strong understanding of cross-benefit integration (medical and pharmacy) and value-based care principles
• Demonstrated success leading enterprise-scale transformation initiatives and driving measurable affordability and quality outcomes
• Expertise in healthcare analytics, predictive modeling, and outcomes measurement frameworks
• Experience managing strategic vendor partnerships, including contracting, performance management, and shared-risk model
• Strong financial acumen, including budget ownership, business case development, and ROI analysis
• Ability to navigate complex regulatory environments, including Commercial, Covered California, Medi-Cal, and CMS requirement
• Exceptional executive presence with ability to influence senior stakeholders and lead cross-functional teams
• Proven track record of building, mentoring, and scaling high-performing teams

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 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 

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• 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.

Please click here for further physical requirement detail. 

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.