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Key skills for this role
In this role, you will:
Identify and prioritize high-impact opportunities to improve IFP performance across cost, access, quality, growth, member experience, and affordability, with a focus on areas of underperformance and measurable results
Analyze performance gaps against plan, benchmarks, OKRs, KPIs, regional targets, and contractual expectations; lead deep dives to identify root causes and quantify business impact
Partner cross-functionally to design, launch, and manage targeted interventions with clear ownership, milestones, success metrics, and expected financial or operational impact
Track intervention impact, measure ROI, evaluate leading and lagging indicators, and refine strategies in real time—scaling successful approaches and adjusting actions when results are not materializing
Support and strengthen performance governance through Pulse of IFP, MBRs, OKRs, KPI reviews, dashboards, decision forums, and leadership updates that drive visibility and accountability
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Coordinate with finance, actuarial, network, HQA, clinical, pharmacy, and provider partners to support CoHC savings, regional affordability efforts, network evolution, provider performance, and pricing-related priorities
Partner with quality, risk adjustment, care management, digital, marketing, and operations teams to improve member engagement, health outcomes, PCP relationship development, care program utilization, and performance against Covered California expectations
Develop executive-ready materials that clearly communicate the “so what,” performance trends, risks, decisions, tradeoffs, mitigation plans, and expected outcomes for IFP leadership
Influence matrixed teams without direct authority, clarify ownership, remove barriers, escalate decisions, and ensure workstreams remain connected to IFP priorities and measurable outcomes
Translate complex data, dashboards, and partner updates into actionable insights, concise narratives, and decision-ready recommendations for leaders and functional partners
Requires a bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
Requires 10 years of prior relevant experience
Requires proven experience leading complex, cross-functional initiatives that deliver measurable financial, operational, quality, customer experience, or growth outcomes
Requires healthcare experience; prefer health plan experience with a strong understanding of business drivers, including cost of healthcare, utilization, provider performance, network strategy, risk adjustment, quality, member engagement, or regulated market performance
Requires demonstrated ability to conduct root-cause analysis, synthesize data, identify underperforming areas, and translate insights into prioritized action plans
Requires experience building and managing governance models, dashboards, operating rhythms, OKRs, KPIs, risk logs, decision frameworks, and executive-level performance updates
Requires the ability to operate in ambiguity, manage competing priorities, influence senior stakeholders, and drive accountability across matrixed teams without direct authority
Requires executive level meeting facilitation, storytelling, and the ability to communicate the “so what” behind performance trends and recommendation
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
Nonprofit California health plan providing insurance coverage to individuals, families, employers, and public-program members.
Visit company websiteJobs and hiring trendsUSD 137720-206690 yearly / year
Full-time
Senior · 10+ years experience
Hybrid
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