Your Role The Network Strategy and Provider Performance team leads the design, implementation, governance, and continuous improvement of strategies, capabilities, and operating models that improve provider performance, quality, affordability, operational effectiveness, and provider experience across Blue Shield of California. The SR Manager, Program Management reports to the Director, Network Strategy and is responsible for leading the operational readiness, performance management, and governance of continuous improvement capabilities that support enterprise and provider-facing initiatives. This role serves as a key connector between strategy and execution, partnering across Healthcare Quality & Affordability, Markets, Network Management, Finance, Analytics, Digital, Technology, and provider organizations to ensure initiatives are aligned, measurable, operationally sustainable, and capable of achieving desired business outcomes. The Sr. Manager develops and oversees operating model capabilities that improve transparency, accountability, readiness, performance monitoring, issue escalation, benefit realization, and cross-functional decision making. This leader proactively identifies risks and opportunities, facilitates organizational alignment, and drives measurable improvements in provider performance and business results. 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:
- Lead implementation and continuous improvement of the Network Strategy and Provider Enablement operating model and governance framework.
- Lead organizational readiness assessments and implementation planning activities supporting provider-facing initiatives and enterprise transformations.
- Lead executive communications, strategic presentations, governance materials, and performance reviews.
- Drive cross-functional collaboration and alignment across HQA, Markets, Network Management, Analytics, Finance, Digital, Technology, and provider organizations to ensure successful implementation and sustained business results.
- Drive development and adoption of standardized operating procedures, playbooks, frameworks, and governance standards.
- Drive continuous improvement initiatives informed by provider feedback, stakeholder input, operational performance metrics, and business outcomes.
- Design and implement processes to proactively identify, assess, escalate, and mitigate risks affecting provider performance and operational success.
- Oversee development and implementation of standardized playbooks, procedures, operational frameworks, and best practices that improve scalability, consistency, and effectiveness of Provider Performance & Enablement programs.
- Lead the development and execution of performance monitoring, forecasting, and reporting processes that enable proactive decision making and early identification of emerging risks and opportunities.
- Establish and facilitate executive steering committees, working teams, governance and stakeholder engagement processes.
- Develop and maintain executive dashboards, scorecards, KPIs, and reporting processes that provide visibility into provider performance, operational readiness, and strategic initiative outcomes.
- Promote a culture of continuous improvement by leveraging provider feedback, stakeholder input, performance data, industry trends, and best practices to identify and implement improvement opportunities.
Your Knowledge and Experience
- Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree.
- Requires at least 8 years of prior relevant experience, including 4 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports.
- Master's degree in Healthcare Administration, Business Administration, Public Health, or related field preferred.
- Experience designing and implementing operating models, governance frameworks, and performance management systems.
- Demonstrated success leading complex cross-functional healthcare transformation initiatives.
- Experience establishing executive reporting, scorecards, KPI frameworks, and performance monitoring programs.
- Strong understanding of provider organizations, provider operations, value-based care, healthcare affordability, quality improvement, and health plan operations.
- Experience conducting readiness assessments, organizational change management, and implementation planning activities.
- Experience developing business cases, benefit realization plans, and outcome measurement strategies.
- Strong analytical capabilities with experience leveraging data to inform decision making and strategic planning.
- Demonstrated ability to influence executive stakeholders and drive alignment in highly matrixed organizations.
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.