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Vice President, Government Programs and External Relations

Location: Rockville, MD Job Number: 610629 Date posted: 06/27/2017
Description: The Vice President of Public Programs and External Relations will:
  • Lead in the development and implementation of strategy for Kaiser Permanente-s Medicare and Medicaid lines of business (and for those individuals dually eligible) in the Mid-Atlantic to achieve membership growth, targeted financial results, and quality outcomes:
  • Ensure integration and coordination of Medicare, Medicaid, charitable health coverage and exchange lines of business; and
  • Oversee the development and execution of strategy for government relations in all three states as well as counties and municipalities to support these insurance programs as well as all public policy and governmental activities affecting KPMAS, its providers, and the populations it serves.

    The Vice President will lead the region in the development of multi-year strategic plans for participation in Medicaid and Medicare throughout Maryland, Virginia and the District of Columbia. Effective planning will require understanding local health care markets as well as the local, state and national political environments. Effective planning will also require understanding the potential membership and financial performance outcomes under different scenarios and strategic options. The resulting strategy will align with all Medicaid and Medicare regulatory and operational requirements. The Vice President will lead the regional governance structure to drive regional leadership alignment regarding these issues. And, s/he will develop systems and processes to monitor performance against national benchmarks, including Medicare and Medicaid 5-Star ratings.
    This work requires partnering with regional senior leadership for Health Plan and MAPMG to leverage capabilities across the organization in support of the Medicaid, Medicare, dual eligible and CHC programs. Such collaborations will enable Kaiser Permanente to not only meet membership targets, financial targets, and quality outcomes but also serve the community, achieve policy and community benefit goals, and retain our tax-exempt status as a nonprofit health plan. Examples include: MSBD (Marketing and Sales for Medicare), Quality, Actuary, Eligibility, Compliance, Clinical Call Center, Permance Analytics, Care Cordination, Physician enrollment/provider relations, and Clinical Call Center.
    This work also requires partnering with and leveraging national leadership and infrastructure for Medicare, Medicaid, dual eligible populations, charitable health coverage and government relations to ensure optimization of results and alignment with national strategies. By participating in the community of practice in these same areas, the leader will facilitate bringing best practices and knowledge from other regions to Mid-Atlantic, bringing Mid-Atlantic practices to other regions, and supporting the spread of best practices across regions.
    Strong and purposeful relationships with government regulators and elected officials is critical to the success of the region. The Vice President must ensure that KPMAS maintains trusted and valued relationships with government officials and regulators in all three states, counties, and municipalities to support this public policy advocacy as well as to contribute to growth in public sector accounts. Especially important will be his/her ability to lead efforts to build strong relationships with state Medicaid agencies, insurance and healthcare regulators, state, county and city elected officials. S/he will develop cooperative relationships with competitor health plans and KP-s interests within each state-s health plan association.
    The Vice President will ensure the Government Relations function: monitors regulations and legislation; identifies needed regulatory or legislative changes; proactively pursues such changes; actively participates in advocacy efforts to achieve needed change; and positions Kaiser Permanente as a thoughtful and effective leader in the Medicaid, Medicare and overall healthcare public policy arenas. The Government Relations team includes Kaiser Permanente employees as well as three outside contract lobbyists in each of the jurisdictions served.

    Finally, the Vice President will maintain close working relationships with the Marketing, Sales and Business Development (MSBD) and Delivery Service Organization (DSO) functions within KPMAS to ensure the region is optimizing growth opportunities and ability to influence public policy to achieve care delivery strategies.

    Essential Responsibilities:
  • Lead efforts within the region to develop and execute realistic and meaningful Medicaid, Medicare and Charitable Health Coverage participation strategies. Work with regional Health Plan and MAPMG leaders to build alignment around these strategies.
  • Directly manage the Regional Medicaid and Medicare leaders and oversee Medicaid and Medicare performance.
  • Responsible for the attainment of financial, membership and quality goals. Develop new metrics appropriate to state goals and regional aspirations.
  • Lead the development and implementation of new Medicaid participation strategies, including MLTSS, Dual Eligible and District of Columbia.
  • Lead the process to convert to Medicare Advantage program.
  • Lead the development of performance improvement plans across for each state, oversee regional implementation of those plans.
  • Ensures that Medicaid and Medicare regional leaders jointly support the development of a new long term Duals strategy.
  • Member of the regional executive leadership in the development of multi-year strategic plans; and integrating planning for Medicare, Medicaid and CHC into the overall regional plan.
  • Responsible for the development of purposeful and positive KP relationships with the state Medicaid agencies, state regulators and elected officials.
  • Create a leadership voice for the value of integrated health care, including integrated managed Medicaid programs.
  • Understand, coordinate, and prioritize support required from regional health plan/MAPMG and national functional areas.

  • Basic Qualifications: Experience
  • Minimum ten (10) years of prior health care leadership experience, preferably in Medicaid or Medicare.
  • BA in business or related area required.
    License, Certification, Registration
  • N/A

    Additional Requirements:
  • Experience and understanding of care delivery issues for low income and vulnerable populations.
  • Experience working with State Medicaid agencies on innovative models as well as negotiating contracts and rates.
  • Competencies in strategic and multi-year planning.
  • Ability to lead in a highly matrixed organization depending primarily on influence rather than organization structure.
  • Ability to work independently.

    Preferred Qualifications:
  • Masters Degree preferred.
  • Demonstrated knowledge base in Medicaid, Medicare, and dual eligibles including knowledge of how care can be successfully delivered to these populations is preferred.
  • Demonstrated experience and success in developing programs in Medicaid Managed Care and Medicare Advantage is preferred.
  • Demonstrated experience and success in new business development in Medicaid and Medicare is preferred.

    Primary Location: Maryland,Rockville,Rockville Regional Offices Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon-Fri Working Hours Start: 8:00 am Working Hours End: 5:00 pm Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Executive/VP Job Category: External Affairs / Relations Department: Regional Leadership Travel: Yes, 20 % of the Time
    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.
  • About Communications Careers

    Careers In Communications

    Communications combines numerous interrelated departments dedicated to advancing the Kaiser Permanente mission, promoting and protecting the Kaiser Permanente brand, and supporting the success of its strategy, including Corporate Communications, Issues and Brand Management, Public Relations, Media and Stakeholder Relations, Public Affairs, and more — both internally and externally.

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