Job Description

Your Role

The Partner Services team leads the selection and implementation of new vendor/provider solutions to support the highest cost and prevalence conditions across Blue Shield of California members. The Clinical Product Senior Principal will report to the Senior Director of Clinical Product Strategy and Innovation. In this role you will build and develop the clinical product strategy and roadmap for high-cost conditions, with an initial focus on Oncology. This role 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.

Responsibilities

Your Work

In this role, you will:

• Strategy & Roadmap: Lead clinical product strategy with LOB, network and clinical leaders with multi-year roadmap aligned to enterprise and market needs.
• Market Partnership: Partner with Commercial and Government Markets to design compliant, differentiated clinical programs through cross functional coordination. This role also includes working with our hospital partners directly to drive value via our partnership strategy.
• Outcomes Measurement: Define outcomes measurement and reporting across clinical performance, engagement, affordability, and ROI.
• Vendor Management: Oversee clinical product vendor performance and partnerships, including contracting, performance guarantees, shared risk, and integration. Clinical buy-up offerings
• Drive cross-functional alignment so teams make consistent tradeoffs and deliver measurable results by influencing priorities, resourcing, risk decisions, and performance outcomes across the organization.
• Continuously improve and evolve the clinical product domain.
• Identify gaps/opportunities, design new or improved programs and processes, and scale them with measurable outcomes (quality, affordability, experience, and ROI).
• Act as subject matter expert in assigned clinical products, governance and performance.
• Understand contract negotiation, financing, managed care and provider relationships.
• Oversee key programs and contracts that impact member pricing, member experience (sales), and cost of healthcare.
• Oversee processes, procedures, and vendor selection which significantly impacts our clinical operations.

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.
• Advanced degree (e.g., MPH, MBA, MHA) preferred
• 12 years prior relevant experience required
• Expertise in medical management, including utilization management, case management, and population health strategy required
• Proven experience developing and executing multi-year clinical product roadmaps in healthcare or payer environments required
• Requires experience working at a health plan (managed care, government payer, or academic)
• Experience working in oncology is preferred
• Strong understanding of cross-benefit integration (medical and pharmacy) and value-based care principles
• Demonstrated success leading enterprise-scale transformation initiatives and driving measurable affordability and quality outcomes
• Expertise in healthcare analytics, predictive modeling, and outcomes measurement frameworks
• Experience managing strategic vendor partnerships, including contracting, performance management, and shared-risk model
• Strong financial acumen, including budget ownership, business case development, and ROI analysis
• Ability to navigate complex regulatory environments, including Commercial, Covered California, Medi-Cal, and CMS requirement
• Exceptional executive presence with ability to influence senior stakeholders and lead cross-functional teams
• Proven track record of building, mentoring, and scaling high-performing teams

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.

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.