What are the responsibilities and job description for the Sr. Director Health Plan Quality & Governance position at Kaiser Permanente?
Oversight of Medicare and Medicare 5 Star, Medicaid Quality programs, Performance Guarantees, HEDIS, Accreditation, Regulatory & Licensing. Have responsibility to work directly with National Quality and oversee HP Quality Oversight Committees. Other responsibilities, quality oversight of network contracted facilities such as hospitals, skilled nursing facilities, DME, utilization management. Familiarity or experience with HRO.
Oversees the development of quality strategies in alignment with KFHP strategic priorities, mission, and vision. Oversees organizational coordination, identifies trends and issues, and directs leaders to create action plans based on reviews of regional quality reports. Engages in external and internal thought leadership to anticipate emerging issues and trends and to identify strategic opportunities for improvement and establishes organizational priorities. Strategically identifies clinical quality improvement possibilities and establishes metrics and goals that will motivate others to develop high impact action plans. Sets a leadership tone for ensuring quality issues are identified and resolved. Serves as a strategic thought leader for clinical quality processes and regulations and empowers others to develop processes and tools to help increase collective knowledge across the organization. Develops capabilities of teams to analyze and monitor key results from data analysis and review and approve quality policies. Leads teams in the oversight of and coordination with the functions of Quality Committees and subcommittees. Establishes standards and processes for the annual approval of Quality Program description, work plans, and annual evaluations
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Minimum Qualification
- s:Minimum four (4) years of experience managing operational or project budget
- s.Minimum nine (9) years of experience in a leadership role with or without direct report
- s.Minimum six (6) years of experience with databases and spreadsheet
- s.Minimum four (4) years of experience delivering training program
- s.Minimum eight (8) years of experience in clinical setting, health care administration, or a directly related fiel
- d.Bachelors degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND Minimum nine (9) years of health care experience or a directly related field OR Minimum twelve (12) years of experience in health care or a directly related fiel
- d.Professional Healthcare Quality Certificate within 24 months of hire OR Professional in Healthcare Risk Management Certificate within 24 months of hir
e.Preferred Qualification
- s:Six (6) years of experience in National Committee of Quality Assurance (NCQA) or related survey
- s.Six (6) years of experience in health care auditing and surve
- y.Six (6) years of experience in project managemen
- t.Master's degree in Business Administration, Health Care Administration, Nursing, Public Health, or related fiel
- d.Certified Professional in Healthcare Quality (CPHQ
- ).Certified Joint Commission Professional (CJCP) or credential(s) from the Healthcare Accreditation Certification Program(s) (HACP
- ).Certified Professional in Patient Safety (CPPS
- ).Registered Nurse License (in the state where care is provided
