Kaiser Permanente Finance Director in Oakland, California

The Financial Director, Analytical Services provides leadership over both national and California (CA) Region-specific activities for the National Medicare Finance (NMF), Analytic Services function. The FinanceDirector manages a team of five (5) professionals located in Oakland, CA.

Specific accountabilities of this role include, but are not limited to:

National Support: - CMS Bidding: Serves as the NMF Lead in the Program-wide Medicare Advantage annual bid submissions to CMS. Activities related to this includes, but are not limited to: - Developis, updates (as needed) and adheres to partnership agreements with Actuarial Services and other bid partners.

  • Works with other Medicare partners, including Actuarial Services and Medicare line of business leadership, in the creation of the extensive and multi-function bidding project plan.

  • Oversees the execution of the national project plan, including adherence to deliverables and deadlines for all regions.

  • Plans and leads regularly scheduled, national bid meetings with partners.

  • Prepares and disseminates detailed guidance, data, reports and tools that are used across all KP regions in support of bid submissions.

  • Ensures development of staff and related business continuity plans to ensure proper and sustainable resource support for bid filings. Directs the coordinating of bid-related training activities, particularly for the NMF team.

  • Participates in bid review meetings upon the conclusion of the bid cycle, identifying and implementing process improvements as needed.

  • Serves as the NMF point person on bid audit inquiries.

  • Medical Loss Ratio Reporting (MLR):

  • Oversees NMF-s contributions to MLR reporting. This includes the development of data used by Actuarial and Accounting colleagues in the calculation of MLR, as well as audit support as needed.

  • Ensures development of staff and business continuity plans to ensure proper and sustainable resource support for MLR filings.

  • Analytic Studies:

  • Directs the preparation and socialization of numerous complex, regional and/or national studies, aimed at informing leaders, partners and clients of the financial performance dynamics of Medicare sub-populations.

  • Directs the preparation and/or application of related predictive models that seeks to assess impacts of strategies or considerations, enhancing or safeguarding both the quality of KP-s Medicare products and services and their affordability.

  • Financial Reporting: Manages the development and preparation of multi-region Profit & Loss (P&L) reporting packages that are shared with national and regional leadership.

California Region Support: - CMS Bidding: Directs NMF staff in the preparation of the annual CMS bid process for the CA Region(s). This includes contributing to strategies (e.g., benefit/pricing decisions, etc.), preparing technical components of the bid (e.g. data development, bid supporting documentation, etc.), and desk review/bid audit support.

  • Strategic Analyses: Creates, conducts and/or oversees the preparation, support, and influence of CA-specific financial analyses that identify and/or support regional Medicare initiatives and strategies. Examples include:
  • service area expansions/reductions

  • new product or service introductions

  • care delivery strategies

  • Financial Reporting: Directs budget to actual and year-over-year reporting and variance analyses, providing insights to regional leaders on actionable areas of opportunity.

  • Monthly Close Activities: Supports monthly close activities, including serving as conduit between NMF and regional Accounting teams

  • Audit Support: Participates and supports in internal and external financial and/or regulatory audits, including the remediation of any potential audit findings.

Other: - Maintains current knowledge of changes in Federal Medicare and HMO regulations and requirements.

  • Participates and supports in internal and external financial and/or regulatory audits, including the remediation of any potential audit findings.

  • Leads, directs, and/or participates, as appropriate, in cross-regional and national work teams.

  • Promotes the sharing and implementation of best practices both regionally and nationally.

  • Manages the resolution of diverse and complex issues where analysis of situations or data requires an in-depth knowledge of multiple functions and KP objectives.

  • Models and reinforces ethical behavior in self and others in accordance to the Principles of Responsibility, adheres to organizational policies and guidelines, and supports compliance initiatives

  • Creates and maintains an environment within the department that enables all staff to meet their full potential individually and as a team. Encourages individual and team THRIVE and community support activities.

  • Oversees and prioritizes the work of NMF staff who support national and CA bidding functions.

Qualifications: Basic Qualifications: Experience - Minimum five (5) years of management experience. - Minimum ten (10) years of related experience. Education - Bachelor's degree in related field. License, Certification, Registration - N/A

Additional Requirements: - Requires expert knowledge of own area of functional responsibility and advanced knowledge of multiple related functions. - Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications: - Master's degree preferred.

COMPANY Kaiser PermanenteTITLE Finance DirectorLOCATION Oakland, CAREQNUMBER 619664

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.