Director, Healthcare Delivery

Your Role

The Network and Provider Partnerships organization is responsible for advancing innovative healthcare delivery models that improve quality, affordability, provider performance, and member experience across Blue Shield of California''s network. The Director, Healthcare Delivery will report to the Sr. Director of Network Strategy and work in close partnership with the Network Strategy, Clinical Operations, Pharmacy, Digital Health, and Population Health leaders. In this role you will bring a unique combination of health plan experience, network management, clinical operations expertise, provider partnership leadership, digital health transformation, and value-based care innovation. You will demonstrate ability to successfully translate strategy into scalable healthcare delivery models that improve member outcomes, provider performance, and affordability.

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 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 experience in healthcare leadership, leading healthcare transformation, network strategy, healthcare delivery innovation, or provider performance initiatives. Building and implementing enterprise-wide strategic initiatives and operational programs, as well as developing executive-level business cases, strategic plans, and performance reporting
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Experience working in network management, clinical operations, health plan, provider organization, or integrated delivery system experience is preferred
• Experience developing and scaling provider-focused digital health or consumer experience initiatives is preferred
• Strong knowledge of healthcare operations, value-based care, population health, and provider partnership models
• Knowledge of specialty care delivery models, including transplant services, cell and gene therapy, and specialty pharmacy is preferred
• Demonstrated ability to lead complex, cross-functional programs within highly matrixed organizations
• Strong analytical, financial, communication, and stakeholder management 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.

Your Work

In this role, you will:

• Strategize Health Care Delivery

• Participate in the development (with the Sr. Director of Network Strategy) and lead execution of enterprise healthcare delivery strategies aligned to organizational objectives

• Develop strategic business cases, implementation of roadmaps, and executive recommendations for healthcare delivery transformation initiatives

• Partner with Network Strategy and Provider Partnerships leadership to establish long-term healthcare delivery priorities and implementation plans to carry out strategies for Network Management

• Partner/collaborate - Provider Digital Transformation

• Partner with Ancillary contracting and provider organizations to develop and implement provider-facing and consumer-facing digital health strategies

• Advance digital capabilities that improve care navigation, access, engagement, and provider experience

• Collaborate with Digital Health, Clinical Operations, and Technology teams to implement innovative digital solutions across the provider network

• Monitor adoption, performance, and outcomes of digital initiatives and recommend enhancements

• Develop Center of Excellence (COE)

• Execute strategy, development, governance, and implementation of enterprise COE

• Collaborate to execute on the design of provider participation standards, quality requirements, operational models, and performance measures

• Implement organizational strategies for programs such as Transplant, Cell & Gene Therapy, and Pharmacy Reimagined

• Collaborate to execute care delivery models supporting specialized and complex healthcare services

• Lead Cross-Functionally

• Facilitate collaboration across Network Strategy, Network Management, Provider Partnerships, Clinical Operations, Pharmacy, Digital Health, Population Health, Medical Management, and Finance

• Influence executive leadership, provider organizations, and key stakeholders without direct authority

• Serve as an execution expert on healthcare delivery innovation and transformation

Your Work

In this role, you will:

• Strategize Health Care Delivery

• Participate in the development (with the Sr. Director of Network Strategy) and lead execution of enterprise healthcare delivery strategies aligned to organizational objectives

• Develop strategic business cases, implementation of roadmaps, and executive recommendations for healthcare delivery transformation initiatives

• Partner with Network Strategy and Provider Partnerships leadership to establish long-term healthcare delivery priorities and implementation plans to carry out strategies for Network Management

• Partner/collaborate - Provider Digital Transformation

• Partner with Ancillary contracting and provider organizations to develop and implement provider-facing and consumer-facing digital health strategies

• Advance digital capabilities that improve care navigation, access, engagement, and provider experience

• Collaborate with Digital Health, Clinical Operations, and Technology teams to implement innovative digital solutions across the provider network

• Monitor adoption, performance, and outcomes of digital initiatives and recommend enhancements

• Develop Center of Excellence (COE)

• Execute strategy, development, governance, and implementation of enterprise COE

• Collaborate to execute on the design of provider participation standards, quality requirements, operational models, and performance measures

• Implement organizational strategies for programs such as Transplant, Cell & Gene Therapy, and Pharmacy Reimagined

• Collaborate to execute care delivery models supporting specialized and complex healthcare services

• Lead Cross-Functionally

• Facilitate collaboration across Network Strategy, Network Management, Provider Partnerships, Clinical Operations, Pharmacy, Digital Health, Population Health, Medical Management, and Finance

• Influence executive leadership, provider organizations, and key stakeholders without direct authority

• Serve as an execution expert on healthcare delivery innovation and transformation