Sr. Medical Director, Provider Performance

Blue Shield of California • Los Angeles, CA

3d • Hybrid

About The Position

The Senior Medical Director, Provider Performance, sits at the center of Blue Shield of California’s efforts to elevate provider performance, clinical quality, and affordability across its entire Commercial network. The incumbent partners closely with Provider Performance, Network Management/Contracting, and internal/external partners to drive measurable provider performance improvements, while supporting key external Commercial clients. This role blends strategic influence with real execution— leading performance improvement for some of the most complex health systems while shaping network strategy, supporting contracting efforts, and delivering on the BSC mission statements. 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.

Requirements

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree.
• Board certification in a clinical specialty.
• Minimum of 7 years of experience in clinical practice.
• Minimum of 5 years of experience in healthcare management, quality improvement, or a related field.
• Experience working with provider networks and health systems.
• Strong understanding of healthcare quality metrics and performance improvement methodologies.
• Excellent communication, interpersonal, and leadership skills.
• Ability to influence and collaborate with diverse stakeholders.
• Strategic thinking and problem-solving abilities.
• Proficiency in data analysis and interpretation.

Nice To Haves

• Experience in a managed care or health insurance setting.
• Knowledge of value-based care models.
• Experience with health information technology (HIT) and electronic health records (EHRs).
• Advanced degree in public health, business administration, or a related field.

Responsibilities

• Elevate provider performance, clinical quality, and affordability across its entire Commercial network.
• Partner closely with Provider Performance, Network Management/Contracting, and internal/external partners to drive measurable provider performance improvements.
• Support key external Commercial clients.
• Lead performance improvement for complex health systems.
• Shape network strategy.
• Support contracting efforts.
• Deliver on BSC mission statements.

Benefits

• Opportunities for personal, professional, and financial growth.
• Supportive workplace environment.
• Recognition as a U.S. News Best Company to work for.
• Recognition as a Deloitte U.S. Best Managed Company.
• Recognition as a Top 100 Inspiring Workplace.
• Recognition by Fair360 as a Top Regional Company.
• Recognition as one of the 50 most community-minded companies in the United States by Points of Light.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Ph.D. or professional degree