Executive Director, Health Plan Service Adminstration

Company Name:
Kaiser Permanente
This position, reporting to the Vice President, HPSA, Colorado, will have primary responsibility for: Colorado Benefit Operations planning, strategic planning, and process improvement to ensure alignment with National Benefits Administration strategy and Regional Strategy. This position will provide leadership to all aspects of regional business performance reviews and represent the region during national business performance reviews, ensuring key milestones are met and corrective action is taken. Leading and directly responsible for all staff performing Benefits Operations work in Colorado. Directing all regional claims, provider contracting and benefits configuration activities and developing and executing the plan to migrate these functions to national shared services. Ensuring that Kaiser Permanente (KP) is positioned to maintain ongoing regulatory compliance with respect to benefits operations processes across the continuum, including maintenance of the CMS and applicable regional regulatory standards of performance. Overseeing the development and maintenance of key operational relationships with Colorado Permanente Medical Groups and Regional Operations for the achievement of quality outcomes for Benefits Administration and ongoing regulatory compliance. Building and maintaining responsive, motivated and efficient departments to ensure results orientation. Partnering with other KFHP/H and PMG executives to ensure leveraging of capabilities and sharing of best practices across the national Benefits Operations organization. Collaborating with other Health Plan leaders for the integration of the major components of initiatives across the regions. Ensuring a productive process is in place for managing HPSA/Regional/Medical Partner escalations and issues to the VP, HPSA, Colorado and National VP, Benefits Administration or to the appropriate governance structure to resolve as needed. Coordinating and consult with key stakeholders, including regional business and medical partners. Enhancing the ability of the organization to achieve high member satisfaction with services provided.
Essential Functions:
- Directs and leads all Colorado Benefits Operation Function, Claims and Provider Configuration.
- Establishes and executes shared service migration strategy for all regional configuration functions.
- Establishes national benefits operations standard processes and structures in conjunction with Benefits Administration leadership team and regional benefits Directors in NW, MAS, GA CA and HI.
Basic Qualifications:
- Seven (7) years of management experience, preferably in a Benefits Operations environment.
- Experience in managing large groups of employees in a collaborative team environment required.
- Experience in managing distributed work locations of common subject matter, variability of operational processes and systems.
- Proven experience operating in an ambiguous work environment with a high degree of independence.
- Bachelor's degree in business administration or related discipline or equivalent work experience required.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
Additional Requirements:
- Strong knowledge of industry standard health plan operation processes and infrastructure with a focus on account installation and benefits administration.
Preferred Qualifications:
- Two (2) to fifteen (15) years of experience in related or similar field preferred.
- Master's degree strongly preferred.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.

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