Blue Cross and Blue Shield Association logo

Director, Market Enablement

Blue Cross and Blue Shield Association
  • El Dorado Hills, CA
    1 day ago

    Job Description

    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 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.

    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 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

    Numbers & Facts

    LocationEl Dorado Hills, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

    Skills

    • Alliance/Partner Managementunmatched
    • Analysis Skillsunmatched
    • Business Administrationunmatched
    • Business Caseunmatched
    • Clinical Outcomesunmatched
    • Communication Skillsunmatched
    • Contract Approvalunmatched
    • Cross-Functionalunmatched
    • Decision Supportunmatched
    • Establish Prioritiesunmatched
    • Financeunmatched
    • Financial Planningunmatched
    • Financial Strategyunmatched
    • Gene Therapyunmatched
    • Health Planunmatched
    • Healthcareunmatched
    • Healthcare Administrationunmatched
    • Healthcare Providersunmatched
    • Healthcare Reimbursementunmatched
    • High School Diplomaunmatched
    • Leadershipunmatched
    • Medi-Calunmatched
    • Medical Treatmentunmatched
    • Medicareunmatched
    • Negotiation Skillsunmatched
    • Network Performance/Analysisunmatched
    • Network Supportunmatched
    • Nursingunmatched
    • People Managementunmatched
    • Performance Analysisunmatched
    • Pharmacyunmatched
    • Product Developmentunmatched
    • Product Planningunmatched
    • Product Programsunmatched
    • Product Strategyunmatched
    • Product Supportunmatched
    • Product/Service Launchunmatched
    • Provider Contractingunmatched
    • Public Healthunmatched
    • Regulationsunmatched
    • Regulatory Requirementsunmatched
    • Reimbursementunmatched
    • Scalable System Developmentunmatched
    • Strategic Planningunmatched

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