Job Description

Your Role

The Healthcare Quality & Affordability Partner Services team identifies, evaluates, and scales innovative, condition specific, value based clinical solutions across the enterprise. In parallel, the Partner Services team owns enterprise health quality vendor governance and clinical product strategy across case management and utilization management in support of delivering measurable affordability, improved clinical outcomes, and sustainable membership growth-while ensuring a seamless experience for both members and providers.

The Director, Clinical Product will report to the Vice President, Partner Services of direct manager. In this role you will partner closely with Commercial and Government Markets to design, deliver, and continuously evolve clinical programs that meet the needs of clients, plan sponsors, Covered California, Medi Cal, and CMS. This role supports the clinical product strategy via sustained roadmaps that enable innovative, scalable, and measurable clinical capabilities in service of Blue Shield's mission to make healthcare affordable, high quality, and accessible for Californians.

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.

Responsibilities

Your Work

In this role, you will:

• Partner with Commercial and Government Markets to design and deliver compliant clinical programs for clients, plan sponsors, Covered California, Medi-Cal, and CMS
• Translate client, purchaser, and regulatory requirements into actionable product strategies and multi-year roadmaps
• Drive product execution that strengthens market competitiveness, improves retention, and supports new business growth
• Lead design and scaling of clinical programs, including ASO buy-up offerings, to deliver measurable outcomes for members and clients
• Define and track performance metrics (clinical outcomes, affordability, engagement, ROI) to demonstrate product value
• Ensure clinical products are operationally scalable, financially sustainable, and deliver positive member and client experience
• Manage vendor relationships and support performance oversight to ensure alignment with quality, cost, and experience goals
• Execute against a defined product domain strategy, including prioritization, roadmap delivery, and performance outcomes
• Translate strategy into requirements, governance processes, and measurable goals across the product lifecycle
• Partner with Clinical, Operations, Technology, Digital, and Analytics teams to deliver integrated, scalable solutions
• Monitor product performance and stakeholder feedback, adjusting priorities to maintain value and relevance
• Communicate product direction, progress, and outcomes to senior leadership, supporting data-driven decision-making
• Perform other duties as assigned

Qualifications

Your Knowledge and Experience

• Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• 10 years of progressive healthcare experience in a payer, provider, or value-based care environment- with emphasis on oncology strongly preferred
• 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Experience in clinical product role at the payer level with specific experience launching payer oncology solutions
• Demonstrated experience leading clinical or health services product initiatives with measurable outcomes
• Strong healthcare and clinical fluency with ability to operationalize clinical concepts into scalable programs
• Proven ability to manage product roadmaps and deliver cross-functional execution at scale
• Data-driven decision-maker with experience balancing quality, cost, experience, and operational considerations
• Effective communicator who can influence stakeholders and align cross-functional teams
• Experience partnering with Commercial and Government Markets and navigating regulatory environments (Covered California, Medi-Cal, CMS)
• Experience managing vendors and supporting performance-based partnerships and program outcomes

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.

About the Team

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.