Job Description
Job Summary:
The person in this position will provide the strategic leadership for Kaiser Foundation Health Plan to deliver sustained and unmatched clinical outcomes across the market. 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. This leader has significant scope of responsibility due to the number of hospitals within the market that require accreditation and regulatory oversight. Essential Responsibilities:
This leader is responsible for the following duties in KP hospitals and ambulatory settings: 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 in the inpatient, ambulatory and post-acute settings. Ensure alignment with national and market policies and programs related to quality and safety. Establish oversight for quality management systems and governance regionally and locally across all components of the clinical organization. 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 PMG executives to set standards, leverage capabilities, share best practices and drive performance across the market. In conjunction with national quality leaders, develop and implement the organizations safety system. Core work includes but is not limited to 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 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. As the market health plan quality leader this individual is responsible for ensuring performance measures related to clinical quality including oversight of clinical registries and associations, safety, care experience, coordination of care, and access are established and regularly overseen by the market quality oversight committee. Where third party accreditation is available as a benchmark for specific operations this leader will collaborate with operational leader to ensure alignment with those accrediting standards. Examples include but are not limited to NCQA (Health plan accreditation), TJC (Hospital and Ambulatory accreditation), and AAAHC (Ambulatory Surgery accreditation). Qualifications:
Basic Qualifications:
Experience Minimum eight (8) years management experience, with a minimum of five (5) years in clinical operations Education Masters degree required in business, nursing, or healthcare. License, Certification, Registration Registered Nurse License (from any state) OR Physician License (from any state) OR Nurse Practitioner License (from any state) OR Pharmacist License (from any state) OR Physical Therapist License (from any state) Additional Requirements:
Proven ability to develop dynamic, constructive working relationships 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 collaborating 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. 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 willingness and competence to dive into the details, as required. Preferred Qualifications:
