Your Role The Network Strategy & Provider Partnerships team is responsible for developing and executing network strategies that support growth, market expansion, product innovation, affordability, and provider performance. The Director, Market Enablement will report to the Senior Director, Network Strategy and serves as a key leader responsible for enterprise network planning and implementation across Commercial, Medicare, Medi-Cal, and Individual & Family Plan (IFP) businesses. You will excel at translating strategic direction into execution plans, coordinate complex cross-functional workstreams, and deliver enterprise results through influence and collaboration. 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:
- Execute Network Strategy & Planning
- Execute enterprise network strategies across Commercial, Medicare, Medi-Cal, and IFP lines of business
- Manage implementation plans, milestones, and workstreams supporting multi-year network roadmaps
- Gather market, provider, and stakeholder insights to support strategic planning and execution
- Drive alignment between network strategy and enterprise growth objectives
- Strategize Provider Renewal & Contracting
- Coordinate and execute enterprise provider contracting and renewal playbooks
- Implement provider segmentation, prioritization, and negotiation frameworks
- Develop strategies for key provider package renewals and enterprise network investments
- Monitor provider market dynamics and competitive trends to inform strategic decisions
- Collaborate closely with Network Contracting leadership on enterprise contracting priorities
- Enable Product & Line-of-Businesses
- Serve as the Network Strategy implementation lead for:
- Commercial Products
- Medicare Advantage
- Medi-Cal
- Individual & Family Plan (IFP)
- Dual Eligible Programs
- Ensure network readiness for new product introductions and benefit designs
- Support enterprise product launches and market entry initiatives
- Partner with Product leaders to align network capabilities with product strategies
- Coordinate implementation activities across business lines
- Lead Market Expansion & Network Readiness
- Implement network strategies supporting service area expansion across all lines of business
- Lead market readiness planning to meet product, operational, and regulatory requirements
- Partner with regional and market leaders to ensure network adequacy and provider access
- Develop scalable implementation frameworks for new market entry
- Coordinate network expansion efforts supporting enterprise growth objectives
- Execute Strategic Programs
- Lead implementation and readiness activities supporting:
- Next-generation products
- Medicare growth strategies
- Medi-Cal expansion efforts
- IFP growth initiatives
- Regulatory and market-entry programs
- Enterprise growth priorities
- Develop Centers of Excellence (COE)
- Transplant Programs
- Support development and implementation of transplant-focused Centers of Excellence
- Coordinate cross-functional implementation plans
- Monitor network performance, access, and member outcomes
- Partner with Network Contracting to support provider relationships and performance
- Cell & Gene Therapy
- Develop provider network frameworks supporting emerging therapies
- Create reimbursement and access strategies
- Partner with Clinical and Pharmacy teams to establish care delivery models
- Support enterprise readiness for new treatment modalities
- Pharmacy Reimagined
- Drive collaboration across Network, Pharmacy, and Clinical teams
- Develop implementation plans with providers and internal stakeholders
- Support initiatives improving affordability, access, and clinical outcomes
- Serve as a strategic cross-functional liaison
- Serve as liaison with multiple teams such as: Network Strategy, Network Contracting, Health Quality & Affordability (HQA), Product Development, Provider Partnerships, Finance, Medicare, Medi-Cal, Commercial Markets, etc.
- Execute highly matrixed initiatives requiring enterprise-wide alignment
- Influence executive stakeholders and support enterprise decision-making
- Facilitate governance and communication across key business functions
- Drive accountability for strategic initiative execution and outcomes
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. Master’s degree in Business Administration, Healthcare Administration, Public Health, Nursing, or related field is preferred
- Requires 10 years of prior relevant healthcare industry experience, including experience within health plans, network management, provider contracting, or product strategy. Experience supporting network expansion, market growth, and product implementation initiatives
- Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
- Experience supporting regulatory programs and market expansion initiatives is preferred
- Experience developing enterprise operating models and implementation frameworks is preferred
- Proven success leading large-scale strategic initiatives and business cases
- Demonstrated success leading highly matrixed, cross-functional organizations
- Strong knowledge of provider reimbursement, contracting, network adequacy, and healthcare market dynamics
- Deep understanding of Commercial, Medicare, Medi-Cal, and Individual Marketplace businesses
- Knowledge of specialty care delivery models, including Transplant Services, Cell and Gene Therapy, and Specialty Pharmacy programs is preferred
- Strong analytical, financial, strategic planning, and executive communication skills
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.