Kaiser Permanente ED, National Provider Strategy in Oakland, California
Reporting directly to the Executive Vice President, Group President, the Provider Strategy executive is responsible for establishing and managing contracting strategies, structures and processes to ensure that regional health plan agreements are designed to meet organizational business objectives while minimizing compliance risks. This leader will drive increased consistency and effectiveness of these agreements through the use of strategic contracting expertise. The leader is accountable for creating a community of practice supporting the tactical and strategic needs of the regional teams and stakeholders. This leader serves as a liaison to the KFHP Board and national functions including Internal Audit, Finance, Quality, Health Plan, Legal, Strategy and Regional Operations.
Conduct program-wide analysis to identify best practices and terms
Create national model for agreements with common components across all regions. Employ best in class provider compensation and incentive strategies to create highly effective agreements aligned with regional business strategies and compliance requirements.
Champion and integrate into the provider agreements a holistic integrated program that works across the care delivery continuum to achieve desired performance.
Support regions in developing multi-year approaches to meet common standards and increase alignment across the program.
After common standards are achieved, this leader continues to identify opportunities for improvement based on KP organizational initiatives, evolving regulatory requirements and other factors.
Coordinate with national and regional leaders on policy, positions and strategy during negotiations. Facilitate review of proposed agreements and ensure alignment with the Group President.
Escalate situations of non-compliance to minimum requirements needed in all agreements
Regularly report status to national leaders and prepare updates as needed for the KFHP Board of Directors
Provide relevant market data, including external benchmarking data, and budgeting support
Drive consistent and appropriate data collection processes across all regions
Create standard tools and templates for contracts and electronic approval process
Create annual process and timing cadence (in the context of other key processes like budget development)
Establish and support communities of practice. This includes conducting training, disseminating information about best practices, identifying areas of common interest and directing initiatives related to regional agreements, facilitating communication and information sharing and providing a forum for alignment with functions impacting or impacted by contracting such as Legal, Actuarial Services and Finance.
Lead annual education for regional accountable executives including regional presidents and CFOs. Support onboarding of new regional presidents and CFOs to ensure understanding of provider contracting strategy and their responsibility / accountability in administering the contracts.
Develop policies / guidelines regarding oversight practices to be employed
Implement reporting that enables effective monitoring of key controls to demonstrate adherence to key agreement details
Engage independent reviews as appropriate to validate data and / or other agreement deliverables.
Minimum ten (10) years of combined experience in managed care provider contracting / network development and hospital / health system administration.
Minimum five (5) years in health care consulting to providers and managed care organizations.
- Bachelor-s degree.
License, Certification, Registration
- Commensurate prior experience that demonstrates leadership in developing and implementing strategic initiatives across a large, decentralized organization using highly leveraged work teams comprised of internal and external staff.
Master's Degree in Business, Health Administration, Public Health with financial emphasis or related field preferred.
Expertise in value-based provider arrangements preferred.
TITLE: ED, National Provider Strategy
LOCATION: Oakland, California
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.