Director, Network Operations

Your Role

The Network Operations team sets the strategic direction for operational processes, network compliance, contract operations, and provider relations for Blue Shield and Blue Shield Promise Health Plan. This work ensures provider contract alignment, supports financial stewardship, strengthens enterprise governance, and advances strategic priorities across multiple lines of business. Reporting to the Vice President, Network Operations, the Director, Network Operations plays a leadership role, guiding data-driven contracting approaches to improve provider network effectiveness while aligning and executing operational initiatives and governance to serve Blue Shield of California and Blue Shield of California Promise Health Plan's (collectively "Blue Shield") best interests. This position works closely with the Vice President of Network Operations to establish priorities while designing a comprehensive execution plan that effectively integrates each of the areas within the department. The Senior Principal will collaborate with multiple areas within the organization to design and implement roadmaps leading to efficient cost of healthcare strategies.

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.

We are actively recruiting candidates within 50 miles of our BSC offices in Woodland Hills, Long Beach, and San Diego ONLY.

Your Knowledge and Experience

• Requires a Bachelor's degree required; advanced degree preferred (MBA, MPH, MHA)
• Requires a minimum of 10 years' experience in health plan operations, including data analytics and project management
• Requires 6 years of management experience
• Lean Six Sigma process improvement certification (Black Belt preferred) or Project Management Professional (PMP) certification strongly preferred or equivalent training and experience
• Proven ability to structure execution across complex programs and initiatives with cross-functional teams
• Requires knowledge in provider contracting, regulatory compliance, and end-to-end health plan operations
• Requires excellent analytical, organizational, and problem-solving skills
• Requires excellent written and verbal communication skills with a proven track record in effective relationship building and influencing stakeholders at all levels of the organization

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.