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, and KFHP/H Board of Directors 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.
Essential Responsibilities: Effectively partner with the market Permanente Medical Group and Health Plan Ambulatory Operations Leaders to ensure care delivery strategies meet regulatory and accreditation compliance with quality, safety, service, and access requirements.Ensure alignment with national and market policies and programs related to quality and safety.Establish oversight for quality management systems and governance.Provides quality oversight on behalf of the KFHP/H Board of Directors for both facility and provider credentialing decisions.Proactively collaborates with key Health Plan and physician leaders at the national level to support the delivery of high quality, cost-effective, integrated healthcare to members and patients.Partner with other KFHP/H and MAPMG executives to leverage capabilities and sharing of best practices across the market. In conjunction with national quality, leaders develop and implement the organization-s safety system. Core work includes but is not limited the following:Develop, implement and fulfill strategic quality and safety oversight objectives that are incorporated into national and regional business plans.Develop, implement and oversee all aspects of Safety and Risk Management including Infection Prevention.Develop and implement quality oversight programs and corrective action plans as needed to ensure safe, timely, effective, efficient, equitable, and person-centered care.Develop and support a patient and family centered care program (PFCC).Collaborate with behavioral health leadership in the market to ensure appropriate quality oversight of behavioral health operations.Responsible for quality oversight of external network contracts.Consistently supports compliance with 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, and reporting noncompliance.Adheres to the applicable federal, state, and local laws and regulations, accreditation and licensure requirements, and Kaiser Permanentes policies and procedures.Develop and implement a quality program for government programs such as Medicare Stars and Medicaid that establishes effective oversight and provides support for performance improvement.Basic Qualifications: Experience Minimum eight (8) years management experience, with a minimum of five years in clinical operations. Education Masters degree required in business, nursing or healthcare. License, Certification, Registration Physical Therapist License (District of Columbia) OR Compact License: Registered Nurse OR Nurse Practitioner License (Virginia) OR Pharmacist License (Virginia) OR Physician License (Virginia) OR Pharmacist License (District of Columbia) OR Physical Therapist License (Maryland) OR Physical Therapist License (Virginia) OR Physician License (Maryland) OR Registered Nurse License (District of Columbia) OR Pharmacist License (Maryland) OR Registered Nurse License (Maryland) OR Registered Nurse License (Virginia) OR Physician License (District of Columbia) Additional Requirements: Service Orientation: Develops long-term strategies and balances resources across a market/service area specifically designed to enhance member/customer satisfaction. Communication: Excellent interpersonal skills (negotiation, listening and communication skills) characterized by effective interactions with a diverse range of internal and external constituents, stakeholders, and audiences. 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. 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. 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. 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. 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: Registered Nurse License (from any state) FACHE
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