Provider Partnerships Director

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.

Responsibilities

Your Work 
In this role, you will:

• Support Vice President of Network Strategy in the development and execution of comprehensive, multiyear regional partnership strategy aligned with enterprise priorities for affordability, quality, access, growth, provider and member experience across all lines of business. Build, strengthen and maintain trusting relationships with providers to work together to deliver care worthy of our family and friends
• Provide thought leadership and collaborate with all applicable business teams, including the Performance Enablement Program team, to co-develop performance and engagement strategy and goals, sharing accountability for P&L and membership growth results including expansion efforts, clinical performance, and cost of healthcare
• Influence enterprise decision-making through regional market expertise and data-driven insight, recommendations, and visibility into regional provider performance, strategic opportunities, and material risks
• Identify, shape and advance innovative provider partnerships and network strategies, including high-value networks, differentiated access models, and other solutions that improve affordability, quality, access, growth and positive outcomes
• Establish and strengthen long-term strategic relationships with health systems, IPA/Medical Groups and other priority providers, fostering collaboration, performance, accountability, affordability and quality improvement, and effective total cost-of-care management 
• Lead and influence cross-functional collaboration across internal departments and provider partners to drive strategic provider engagement initiatives that achieve measurable business outcomes
• Oversee the planning, execution, and continuous optimization of engagement strategies, ensuring seamless coordination, enhanced provider experiences, and strong regional performance 
• Direct and develop a team of program managers, establishing clear accountability, performance metrics, and data-driven insights to evaluate success, identify opportunities for improvement, and advance organizational goals
• Understand and capitalize on the competitive market and identify opportunities for the provider strategy accordingly
• Drive the financial performance of your portfolio supported by the Finance Team (planning, reporting, performance management, contract support, capitation payments, analysis, coding and budgeting)
• Foster a culture of innovation and creativity to enable BSC to meet changing market conditions and strategy
• Build a high-performing team that meets all operating goals, including cost of healthcare, clinical quality improvement, regulatory compliance, administrative cost, and employee engagement

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
• 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.

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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.