In collaboration with regional health plan and medical group executives, and in partnership with the market Medical Director, develops and executes strategy and corresponding action plans that drive successful delivery of KP's mission of high quality affordable health care. In partnership with functional leads in the market, accountable for full operations for assigned market, including sales, revenue collection, provider network development and management, internal care delivery operations, among other operational areas. Maintains partnerships with hospitals, network providers and key stakeholders in the community. Strengthens the reputation of KP Colorado in community which helps support objectives around healthy membership growth and strong financial results. Success in this position will require a fiscally sound market strategy that generates returns at targeted levels, while maintaining and strengthening quality and service levels.
Essential Functions:
- Provides leadership for assigned market, with responsibility for revenue and expenses, or Profit & Loss Statement (P&L), while assuring delivery of high quality, affordable care resulting in membership growth.
Membership Growth:
- Works with Marketing, Sales & Business Development (MSBD) team to develop attractive products for all lines of business (LOB).
- Maintains and builds understanding of market dynamics, keeping a pulse on both partner and competitor activities, as well as general market trends and opportunities.
- Continually engages KP's current and future customers, both directly and via brokers/consultants, to understand their needs in terms of product design, pricing, access to services, etc.
- Is involved in community-based organizations seeking to improve the quality of life for market residents, with a focus on healthy living and Total Health.
Care Delivery:
- In partnership with other functional leaders, directs the day to day operational activities of market medical services and provider relations contracting staff. Facilitates management of provider networks, provider education and provider relations.
- Assures that quality and service objectives are achieved. Works with broader regional teams to deliver the highest quality health care in the market, as measured by both internal and industry standards (e.g., HEDIS, Medicare 5 Star).
- Develops and supports the adoption of best practices. Also works to improve interoperability with contracted network providers, to support quality, service and financial objectives.
- Is responsible for external and internal care delivery strategy and operations, in partnership with market Medical Director and functional leaders.
- Works with regional Network Development & Provider Contracting team, representing regional interests in complex contract negotiations for the provision of cost effective medical services. Partners with CPMG leadership for professional including physician services.
- Manages and leads staff in a way that promotes strategic alignment, operational flexibility, and high levels of engagement. Includes long term development to support the objectives of the region and of Kaiser Permanente overall.
Financial:
- Leads the development of market and associated department annual operating budgets. Includes membership, revenue, expense, operating income, and capital return measures. Will be held accountable for achieving these objectives.
- Provides frequent performance reports to regional leadership, demonstrating specifics on appropriate plans and performance against those plans.
Qualifications:
Basic Qualifications:
- Master's degree or equivalent experience in business administration, health care administration or related field is required.
- Seven to ten years of health care operations management experience, with demonstrated ability to lead strategy development and execution, is also required.
- Must have excellent business and operations experience, partnership and collaboration, community engagement, problem solving, oral and written communication, and negotiating skills.
- Must share the values of Kaiser Permanente and its Leadership Team, have a dedication to diversity, and willingness to be a strong role model for effective leadership practices.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.