VP, Partner Services

Your Role

The VP, Partner Services will report to the SVP, Healthcare Quality & Affordability (HQA) Operations. This leader will be vital to leading the clinical program strategy and performance for HQA by developing a robust vendor portfolio established through modernized value-based contracting for all lines of business. The VP, Partner Services will lead contract negotiation for new and emerging programmatic needs while developing and maintaining vendor performance metrics and reporting. The VP, Partner Services will understand and identify opportunities to expand and improve member options through their subject matter expertise driving significant impact to cost of care. This role will develop a business rhythm to monitor and evaluate and analyze the performance clinical programs. This leader will be accountable for member satisfaction, resolution of escalated issues, cost of healthcare savings and clinical quality improvement and outcomes for Blue Shield's members.

Your Knowledge and Experience

• Bachelor's degree in Business Administration, Healthcare Administration or a related field required.
• Master's degree, especially an MBA focused on healthcare, Master of Public Health or related field preferred.
• Requires a minimum 15 years prior relevant experience, including 8 years of management experience.
• A minimum of 8 years of health plan operations experience required including contract administration, risk management and compliance.
• Understanding of contract negotiation, financing, managed care and provider relationships required.
• Working knowledge of California regulatory and accreditation standards required (URAC, NCQA, DMHC, CMS, DHCS)
• Requires demonstrated experience in driving operational performance and efficiencies on a large scale.
• Requires broad management knowledge to lead teams and build relationships in a highly matrixed environment.