Senior Vice President, Government Markets

Your Role

The Senior Vice President, Government Markets has overall accountability for strategic leadership, financial performance, and operational success of Blue Shield of California's government sponsored health plans. This role will lead the team of Government Markets executives including Medicare, Individual and Family Plans (IFP), and Blue Shield Promise Health Plan (Medi-Cal). This executive will lead growth initiatives, ensure regulatory compliance, optimize financial performance, and cultivate key partnerships with providers, regulators, and stakeholders.

Reporting to the Executive Vice President, Chief Growth Officer, the SVP will work with other senior leaders across the enterprise to enhance BSC's market presence and deliver on its mission to provide high, quality sustainable healthcare. This role requires a visionary and results-driven leader with deep expertise in government programs, regulatory frameworks, and healthcare market dynamics. Their ability to influence, foster collaborative and strategic relationships throughout the enterprise, with key government regulators and work across the cycle of healthcare will be critical, along with a deep knowledge of the government programs around Medicare, Medi-Cal, and the Covered California healthcare exchange. This role requires a thoughtful leader who is deeply committed to the CEO's success and the achievement of Blue Shield's mission.

Your Required Knowledge and Experience

• Bachelor's degree required.
• 15+ years of executive leadership experience in multi-state health plan operations, government programs, or managed care organizations.
• Proven leadership in overseeing Medicare Advantage, Affordable Care Act (ACA) exchange plans, and Medicaid (Medi-Cal) programs at a regional, state, or national level.
• Led a turnaround strategy for government health programs by implementing strategic initiatives that improved financial sustainability, operational efficiency, and member experience.
• Deep expertise in regulatory compliance with Centers for Medicare & Medicaid Services (CMS), Department of Health & Human Services (HHS), state Medicaid Agencies (such as California Department of Health Care Services, DHCS, in California), and Affordable Care Act (ACA) marketplace regulations.
• Strong financial acumen and leadership experience managing Profit & Loss (P & L), capitation models, risk-sharing arrangements, and cost containment strategies.
• Executive-level collaboration with regulatory bodies, state health agencies, and key internal and external stakeholders to drive policy and operational effectiveness.
• Proven ability to drive membership growth, retention, and financial sustainability in government health programs.
• Experience managing external relationships with government agencies.

Preferred Experience

• Advanced degree ((Master of Business Administration (MBA), Master of Healthcare Administration (MHA), Master of Public Health (MPH) or related field)).
• Familiarity with population health initiatives value-based strategies and provider risk-sharing arrangements.
• Experience leading health plan expansions, responding to state/federal RFPs, or launching new-government-sponsored products and programs.
• Strong knowledge of California healthcare regulations, Medi-Cal managed care models, and ACA market dynamics.
• Experience managing relationships with California's Department of Managed Health Care (DMHC) and Covered California.