Under the direction of the Southern California Executive Director for Quality & Risk Management, the Managing Director for Health Plan Quality & Regulatory Oversight is responsible for:
The oversight of development, planning, management, and integration of Southern California KFH/HP organizational programs related to:
Quality Operations, Behavioral Health Regulatory Oversight, Accreditation, Regulations and Licensing areas, emerging Regulations/Legislations. This position will lead highly visible, complex and politically risky improvement projects that are of strategic importance to the company. This position will oversee the development and execution of action plans/deliverables. This position will also oversee, design, support and lead any necessary communication and governance/oversight mechanisms required. This position is responsible for building relationships and ongoing interaction with facility quality leaders and Senior Leaders to ensure the direction of the departments, functional areas, programs and initiatives are in alignment with organization-wide goals and priorities. Ensures consistency of operational system processes and standards according to the region's strategic business plan related to quality.
Identifies and institutes enhanced quality practices based on benchmarking with other industries and internal practice transfer.
Facilitates the rapid transfer of best practices across geographical boundaries. Participates in state networks and provides a presence to highlight the organization's leadership and innovation in the health care industry. Recommends adjustment to operations to meet changing business and market conditions, and ensure continued high levels of performance with regulatory and accreditation requirements.
Employs effective change management techniques.
Essential Functions:
- Provides operational leadership and consultation to Southern California executive management, SCPMG, and Southern California service areas on clinical, regulatory, service, quality and utilization management related practices across the continuum of care. Identifies and institutes enhanced quality practices based on evidence based outcomes and industry standards.
- Provide leadership and expert consultation on the design, development, and implementation of programs related to the expertise area. While providing overall strategic direction for complex projects may also assume the role as the manager of one or more technical units.
- Provides for the development, implementation, and evaluation of effective clinical and service quality programs, policies, standards, practices, and procedures consistent with organizational objectives and the KP Promise.
- Partners with and has accountability with risk management, patient safety and quality leadership, SCPMG, and Patient Care Services to produce improved quality outcomes in the hospitals.
- Expertise in federal/state regulations and accrediting agency standards and works in collaboration with Medical Centers and Regional departments to ensure compliance to various regulatory surveys. Responsible for providing oversight to quality, accreditation and licensing at each medical center through awareness of local processes and coordination of updates to Regional Quality Committee.
- Directs and coordinates with Program Office and KP regions for quality functions.
- Accountable to achieve outcomes related to improving quality of care and service.
- Hires, performs disciplinary actions, provides employee training/development, and conducts performance assessments.
- Develops and monitors the payroll, non-payroll, and capital budgets for assigned areas of responsibility.
Qualifications:
Basic Qualifications:
- Clinical and operations background required.
- Departmental management experience required.
- Extensive experience, typically ten years or more years, in a leadership role for a multi-faceted health care system.
- Master's degree in Business, Health Care, Public Administration or related field.
- Proven ability to develop quality standards, policies, processes that impact multiple groups.
- Effective and superior verbal and written communication skills, facilitation skills, and presentation skills required.
- Demonstrated critical thinking, influencing, problem solving, and analytical skills required.
- Excellent leadership and strategic thinking skills and the ability to drive business results by motivating staff.
- Knowledge of the contemporary issues in the areas of quality management with demonstrated results addressing these issues. Decisiveness, action-orientation, personal integrity, capability to persevere in difficult situations and a focus on strategic leadership issues required.
- Incumbent should also possess an open, collaborative leadership style that promotes teamwork and partnership while achieving desired results.
- Demonstrated ability to lead professionals through influence and collaboration.
- Proficient in team building, conflict resolution, change leadership, systems thinking, group interaction, results orientation and budget management.
- Demonstrated knowledge of the intricacies of hospital/HMO/medical office operations and practices.
- Proven leadership skills in complex analytic problem solving, project management and consulting especially on highly visible, politically sensitive issues, change management, and group process. Understanding of KP operations and competitors, and economic, social, and legal environment.
- Advanced knowledge of computer applications and knowledge of data systems required.
- Must be able to work in a Labor/Management Partnership environment.
- Demonstrated ability to determine the key business issues and develop appropriate action plans from multidisciplinary perspectives.
- Must demonstrate an understanding of health policy trends and any applicable regulations related to the responsible technical area.
Preferred Qualifications:
- CPHQ preferred.
- Established track record with Kaiser Permanente preferred, particularly in working across geographic and entity boundaries and with multidisciplinary teams.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.