Description

Job Summary:

The person in this position will provide the strategic leadership for Kaiser Foundation Health Plan to compete as the quality leader in health care. On behalf of the Health Plan, the individual in this role has the overall responsibility for ensuring the quality, safety, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system. This leader is responsible for effectively partnering with the market Permanente Medical Group to ensure care delivery strategies meet regulatory and accreditation compliance; align with national and market policies and programs related to quality and safety; and establish/oversee quality management systems and governance. This role functions on behalf of the KFHP/H Board of Directors to provide effective quality oversight of both facility and provider credentialing. This leader is also responsible for proactively collaborating with key Health Plan and physician leaders across the national system to support the delivery of high quality, cost-effective, integrated healthcare to members and patients. The leader in this position will partner with other KFHP/H and PMG executives to ensure the leveraging of capabilities and sharing of best practices across the market. Core work includes but is not limited to: the development and implementation of strategic quality and safety oversight objectives that are incorporated into national and regional business plans, development and implementation of quality oversight programs and corrective action plans to ensure continuous quality improvement, and the development and monitoring of appropriate measures for safe, timely, effective, efficient, equitable, and person-centered care that assess the impact on the health of our members and the communities we serve. This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state, and local laws and regulations, accreditation and licensure requirements (if applicable), and Kaiser Permanentes policies and procedures.

Essential Responsibilities:

• Directs a high functioning team of quality and safety professionals who oversee quality, safety, infection prevention, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system.
• Partners with Permanente Quality to provide overall leadership of the KP market-s quality of care program for the delivery system including its ambulatory, inpatient, dental, continuing care services as well as contracted hospitals and network providers.
• Partners with the Hospital Administrator(s) to provide leadership and oversight of the Hospital Quality program, ensuring that activities are in alignment with, approved, and directed by the Board of Directors (QHIC).
• Drives, and when appropriate, partners with market PMG quality and / or operational leaders in the development of quality oversight programs and systems that position Kaiser Permanente as the quality leader in the marketplace through participation in relevant externally benchmarked measurement programs (e.g., HEDIS, CMS 5 Star, NCQA, Patient-Centered Medical Home, Leapfrog).
• Identifies obstacles, barriers, and issues impacting the KP market-s ability to meet its quality, workplace safety, patient safety, clinical risk management and regulatory goals and objectives.
• Represents the KP market in strategic matters locally and nationally, relating to issues of clinical quality, service quality, safety, and risk (e.g., market quality oversight committees, KPNQC, SERCIT, Board of Directors).
• Collaborates with national functions for example the Care Management Institute (CMI), the Medicare Inter-regional Program Management Organization (IRPMO), and other functional units within the KP enterprise to obtain appropriate, on-going data on quality outcomes and member and community health status improvements.
• Leads Quality Program Administration, (i.e., QHIC processes) including quality management oversight, health care delivery oversight, assessment, and intervention.
• Supports Population Health Community of Practice to develop strategic prevention plan, implement program guidelines, and develop program evaluation and monitor outcomes for members- health using HEDIS targets and outcomes.
• Partners with care delivery leaders by providing timely and accurate quality and regulatory advice, information, consultation and continually measures satisfaction of accountable services.
• Collaborates with Compliance and operations to minimize clinical risk and maximize quality outcomes.
• Ensures Accreditation, Regulatory Compliance and Licensing as appropriate.
• Directs activities to ensure that the KP market obtains and maintains full NCQA accreditation, meets CMS, state and other regulatory requirements achieving the highest award recognition. (Examples: Medicare 5-star, Joint Commission, Det Norske Veritas, American Heart Association)
• Ensures effective execution of business strategies by aligning human resource strategies with business needs, by recruiting and developing a high-performance team, and by creating a climate, which builds employee commitment and reinforces performance, customer service and quality, and service outcomes.
• Effectively contributes to and utilizes national strategies and capabilities; promotes and implements active sharing of new learnings and innovations.
• Develops and implements an approach to quality and licensing/regulatory services that integrates strategy with day-to-day operations.
• Provides interface between Health Plan and the market Permanente Medical Group for a variety of initiatives including, but not limited to, quality and safety oversight.
• Drives internal initiatives that improve overall performance by addressing unreliable, poorly controlled, ineffective, inconsistent, and duplicative processes and functions.
• Builds and maintains responsive, motivated, and efficient departments that ensure results orientation.

This position has a target base salary of $279,000 to $348,750 and is eligible for incentive compensation, an executive allowance, comprehensive health, wellness, time off, savings, and retirement benefits, as well as relocation support, as applicable.

Basic Qualifications:

Experience

• Minimum eight (8) years management experience, with a minimum of five years in healthcare operations.

Education

• Master-s degree required.

License, Certification, Registration

• Registered Nurse License (from any state) required at hire OR Pharmacist License (from any state) required at hire

• Pharmacist License (Oregon) within 3 months of hire OR Registered Nurse License (Oregon) within 3 months of hire

Additional Requirements:

• Service Orientation: Develops long-term strategies and balances resources across a market/service area specifically designed to enhance member/customer satisfaction.
• Listening: Obtains clear understanding of various stakeholder/participant needs, priorities, and concerns into balanced, effective agendas, programs, and strategies.
• Integrated Thinking: Synthesizes varied and disparate points of view, needs, priorities, and concerns.
• Communication: Tailors communication style to engage audience and convey the rationale for decisions. Translates aspirations and strategy into action steps and creates commitment to the plan.
• Influence: Builds program wide relationships to move initiatives forward and positions ideas to enhance likelihood for success.
• Team Focus: Models collaboration in building plans and strategies to enhance organizational clarity. Adapts management style to enable optimal team performance.
• Change Leadership: Sustains long-term change process (3 years), builds commitment by explicitly laying out a clear change road map and monitoring progress.
• Decisiveness: Uses understanding of key business goals and strategies to make decisions that address key business threats and opportunities.
• Results Orientation: Takes calculated risks after making fact-based decisions to improve organizational performance. Tracks and measures results against external best practices.
• Cultural Competence: Strategically builds a diverse employee base and creates services to enhance ability to serve diverse local populations.
• Develops Others: Coaches and mentors future leaders and develops individual plans to accelerate their growth.
• Personal Development: Actively seeks and accepts challenging opportunities that will help meet identified development needs. Demonstrated ability to achieve performance outcomes through others.
• In-depth knowledge of and leadership experience with Health Plan hospital and medical group requirements for quality oversight, and accreditation and regulatory compliance.
• Leadership experience working with regulatory agencies and dealing with integrated care delivery systems and coordinated care issues.
• Demonstrated leadership capabilities, including but not limited to:
• Excellent analytical and problem-solving skills.
• Proven capability to motivate change and galvanize action through synthesis and interpretation of financial and outcome data.
• Consistent delivery of results to the satisfaction of internal and external customers.
• Proven ability to balance execution of the strategic vision through leadership and delegation, with a willingness and competence to dive into the details, as required.
• Proven ability to develop dynamic, constructive working relationship and partnerships with operational physician and labor partners.
• Willingness to challenge the -status quo,- and active risk taker.
• Excellent interpersonal skills (negotiation, listening and communication skills) characterized by effective interactions with a diverse range of internal and external constituents, stakeholders, and audiences.
• Demonstrated political savvy-Able to operate in politically complex situations and remain effective.
• The ability to balance strategic development and day-to-day operation responsibilities.
• Proven experience in working with the community in leadership roles.
• Must possess excellent interpersonal skills and the ability to work and communicate at the most senior levels within Kaiser Permanente and the external market.
• Demonstrated creativity and change agent skills.
• Strategic/Systems Thinking: Uses understanding of complex internal and external variables to formulate work unit strategy (3 years) in support of organizational strategy.

Preferred Qualifications:

• Graduate degree in business administration, nursing, or health care administration is preferred.
• Current RN license preferred.

Primary Location: Oregon,Portland,Kaiser Permanente Building
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon to Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE Executives|NUE|Non Union Employee
Job Level: Executive/VP
Department: Po/Ho Corp - Rgnl Clrng-Northwest HP - 0308 Travel: Yes, 10 % of the Time Flexible: Work location is on-site at a KP location, with the flexibility to work from home. Worker location must align with Kaiser Permanente's Authorized States policy. Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
Requisition #: 1384549

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