ED, Medicaid - Strategy and Performance
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Reporting to the National Senior Vice President of Medicaid, the Executive Director of Medicaid Strategy and Performance is a key leader that manages and communicates the strategic and performance initiatives for Medicaid, as well as oversees budget, business development opportunities (including RFPs), portfolio management and governance. The position involves close coordination with a variety of KP regional, national, and shared service leaders and functions.
The Executive Director of Medicaid Strategy & Performance maintains relationships and represents KP with a variety of external partners and stakeholders.
- Coordinate and prioritize support from national functional areas (for example actuarial, finance, legal, and compliance.) Collaborate with National Medicaid Executive Team to gain alignment and drive initiatives that improve performance. Support enterprise-led strategic planning efforts, ensuring inclusion of Medicaid-s perspective.
- Oversee development and execution of Medicaid LOB national strategy, defining corresponding initiatives and goals and tracking to completion. Provide ongoing strategic assessments of the external environment, analysis and recommendations. Continually scan the external environment and educate the regions regarding the competitive marketplace including what competitors across states are doing in Medicaid, identifying external best practices.
- Responsible for portfolio execution and progress reporting of Medicaid initiatives. Supports all Medicaid LOB governance forums including Medicaid Team Meetings, Town Halls, Quarterly Business Reviews, Executive Update and all leadership communications.
- Monitor financial, membership, quality, and other performance metrics and partner with Medicaid-s Executive Director of Shared Services on development of new metrics. Play a key role in the evaluation of current metrics, their appropriateness, and what new metrics may be necessary. Drive to consistent metrics across markets where applicable.
- Partner with the appropriate market leadership to monitor the performance of regional Medicaid plans. Partner with markets to ensure that the right level of resources is supporting the Medicaid Business Line. Work with markets to insure that there is adequate staffing and support from national functions/shared services and functional areas to appropriately run the Medicaid line of business.
- Assist regions in development of RFPs and new product offerings. Drive the development of safety net partnerships as appropriate to support Medicaid care delivery. Assist markets in the development of other partnerships such as with other health plans, regional ACOs, and others.
Basic Qualifications:
Experience
- Minimum ten (10) years of professional experience in the health insurance business or in a consulting role focused on projects supporting Medicaid, Medicare and other government sponsored programs or care delivery systems supporting low income and vulnerable populations.
Education
- BA in business or related area required
License, Certification, Registration
- N/A
Additional Requirements:
- Extensive knowledge and expertise in Medicaid and CHIP
- Demonstrated experience and success in health plan and/or care delivery operations and business development in Medicaid Managed Care
- Prior healthcare leadership experience for five or more years, including Medicaid and other State Sponsored programs
- Understanding of KP and integrated health plan and care delivery models and issues
- Competencies in strategic, financial, and operational planning and program management
- Ability to lead in a highly matrixed organization including the ability to establish, lead and collaborate effectively through influence and relationship, rather than through reporting relationships
Preferred Qualifications:
- Experience working with State Medicaid agencies on innovative models as well as negotiating contracts and rates is preferred
- Experience in Medicare Advantage or in programs serving dual eligible preferred
- Master’s Degree preferred
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
