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Health Care & Hospital Operations

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VP, Continuum of Care-Colorado Region

Location: Aurora, CO Additional Locations:
Job Number: 793682 Date posted: 04/25/2019

The Vice President, Continuum of Care is a leader responsible for oversight and monitoring of the planning and implementation of Utilization Management operations and activities ensuring continuing care services and hospital care, community capacity management and strategic resource planning for members in all product lines for Kaiser Permanente of Colorado. In partnership with leaders and staff across the region and in Program Office, the Vice President is responsible to develop and implement the vision for quality care across the continuum and to create systematic opportunities for KPCO to continue to develop and lead as a community health system in accordance with regional and organizational goals and objectives. This position is expected to measure systems, operational processes, goals and investments to effectively improve the performance of the region. This position has administrative, operational, financial, regulatory, and planning accountability for continuing care services in Prior Authorization, Concurrent Review, Discharge Planning, Appeals Resolution, Home Health, Hospice, Palliative Care, Rehab Services, Dialysis/ESRD,EPRP, Population Management, SNF, Medical Transportation/Ambulance Services, Outside Medical Services and Referrals, DME, and other related Utilization Management functions.

Essential Responsibilities:
-  Develops and implements a regional hospital and provider strategy to improve our quality, service, access and affordability mission.
-  Provide executive level leadership, strategic direction and recommendations over areas of accountability including prior authorization, concurrent review, discharge planning and care management and related utilization management activities
-  Identify and implement actions in areas of accountability to improve quality, service, financial performance and compliance.
-  Executes continuing process improvement, implementation, performance improvement and measurements of improvements.
-  Effectively uses metrics and data to measure and monitor performance while identifying and leading initiatives that close gaps with additional opportunities and interventions.
-  Executes interventions to ensure appropriate utilization results inclusive of venue, quality and cost management objectives.
-  Manages the structure and processes to develop, implement and assure success of all areas related to the Continuum of Care, including the integration, coordination and management of care and services for Outside Medical Services.
-  Participates in an integrated fashion with other areas of clinical activity creating an environment of partnership with stakeholders internally and externally in the marketplace.
-  Directs other activities as assigned that improve care to our members and the communities we serve
-  Ensuring that Kaiser Permanente (KP) is positioned to maintain ongoing regulatory compliance across the continuum of care, including NCQA accreditation, Medicare 5 Star compliance, DPH and CMS care delivery compliance.
-  Develops and monitors the payroll, non -payroll, and capital budgets and expenditures for assigned areas.
-  Champions and implements care delivery innovations to achieve organizational goals.
-  Explores critical issues related to the Continuum of Care and Care for specific populations; such as complex needs patients.
-  In partnership with key constituents, develops and implements the future vision for care across the continuum and as a community health system.

Basic Qualifications:
-  Minimum ten (10) years of progressive management experience, and twelve (12) years of directly related experience.
-  Bachelor's degree in health services, business administration, public health or related discipline required.
License, Certification, Registration
-  N/A

Additional Requirements:
-  Demonstrated results in utilization management, care coordination and management of outside medical services.
-  Demonstrated proficiency and knowledge in analyzing and interpreting medical management and financial trends.
-  Requires knowledge of the health care delivery system.
-  Requires knowledge of case management/clinical program interventions and measures.
-  Requires broad clinical knowledge.
-  Requires knowledge of current Utilization Management, Case Management, and Pre-Admissions strategies.
-  Requires knowledge of the nature and treatment of diseases and side effects of related therapy methods.
-  Requires broad knowledge of Managed Care Organizations.
-  Must have knowledge of supportive care principles.
-  Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications.

Preferred Qualifications:
-  Master-s degree in related field

Primary Location: Colorado,Aurora,Waterpark I 2500 S. Havana St. 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: Non-Union, Non-Exempt Job Level: Executive/VP Job Category: Healthcare / Hospital Operations Department: Hospital Operations Travel: Yes, 15 % of the Time 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.

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 and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

About Health Care & Hospital Operations Careers

Health Care & Hospital Operations Careers

Envision the future, inspire change, and deliver results. Put your talents to work not just at a powerful business, but at an organization dedicated to empowering the health and well-being of millions. As a valued member of the Kaiser Permanente team, your visionary and strategic contributions are especially vital to our success. Come drive change within the organization and across the future of health care.

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