Skip to main content

Service, Care Experience Leader

Location Harbor City, California Job Number 1006388 Date posted 10/11/2021
Submit Interest

Navigating the Hiring Process

We're here to support you!

Having trouble with your account or have questions on the hiring process?

Please visit the FAQ page on our website for assistance.

Need help with your computer and browser settings?

Please visit the Technical Information page for assistance or reach out to the web manager at kp-hires@kp.org.

Do you need a reasonable accommodation due to a disability?

A reasonable accommodation is any modification or adjustment that enables you to fully participate in completing the following:

  • Online Submissions
  • Pre-Hire Assessments
  • Interview Process

Please submit your accommodation request and an HR Representative will contact you.

Description:
Accountable for Service and Access performance of the Service Area. Responsible for the strategic development, monitoring and communication of service and access programs within the Service Area. In conjunction with Service Line Administrators and leaders, develops and implements quality and utilization standards to determine the most cost-effective, efficient levels of patient care. In conjunction with physician leaders, develops and implements quality and utilization standards and targets to optimize clinical, service and access outcomes. Ensures that policies, practices, and procedures comply with administrative, legal and regulatory requirements of Health Plan contracts and governmental and accrediting agencies.


Essential Functions:

- Develops and implements operational improvement initiatives related to member access to healthcare and member and patient satisfaction.
- Conducts detailed analyses for barriers to high service and access performance; works with department managers to develop effective action plans.
- Facilitates identification of and transfer of successful practices in service and access across departments.
- Monitors and assesses service and access trends locally in the Service Area, as well as the external Southern California market.
- Makes thoughtful recommendations to develop and/or adjust current strategy to meet the changing business environment.
- Sets service and access targets based on benchmarks to increase the Service Area's competitive edge.
- Coaches, manages and develops training materials to build a culture of extraordinary customer service.

- Establishes effective professional business relationships with all levels of management.
- Makes formal presentations to various senior level audiences.
- Ensures NCQA and TJC standards for service and access are met.
- Ensures compliance with regulatory standards, including TJC, NCQA, DMHC, and Medicare, to include responsibility for accurate Encounter coding.
- Manages utilization of appointment resources, overseeing development of demand/supply models and consulting to Chiefs and MSAAT on Effective Utilization of resources, in order to maximize member value and meet regulatory requirements.
- Designs and implements systems improvements which result in a superior care experience by improving patient flow, clinical support , customer service, etc.
- Optimizes Quality patient care through monitoring of systems for access and service, including closed loop message system, Optimal Office Practice Systems, Forms and letters system, etc.
- Provides smooth assimilation of new members into a service area.
- Collaborates with the service area management team to develop the overall strategic business plan.
- Assures short and long-range goals are met by establishing and controlling the processes and systems and ensuring managers are meeting their accountability's.
- Monitors and assesses quality and utilization trends, external environment and internal practices, makes recommendations to develop/adjust strategy to meet the changing business and market conditions.
- Develops, coaches and manages a staff dedicated to providing expertise and customer service.
Basic Qualifications:


Experience
- Minimum seven (7) years of experience in operational management roles in a health plan or multifaceted health care system and multi-provider settings.
Education
- Master's degree in business, health care, public administration, or related field OR six (6) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
 
Additional Requirements:
- Thorough knowledge of quality assurance, quality improvement, utilization review, risk management, and accreditation and licensing process required.
- Thorough knowledge of federal and state laws and regulations.
- Ability to design and implement systems which support access and service.
- Able to determine key business issues and develop effective departmental action plans from multi-disciplinary perspectives.
- Able to think strategically in structuring work results and effecting change.
- Demonstrates ability to lead and manage others through influence and collaboration.
- Contributes to the organization's attainment of service and access goals.
- Participates with peers to ensure the rapid transfer of best practices.
- Excellent leadership, facilitation, and consulting skills.
- Excellent verbal and written communication skills and interpersonal skills.
- Works closely with physician and operational leaders to assist them in meeting performance targets and customer expectations.
- Must be able to work in a Labor/Management Partnership environment.

 

Preferred Qualifications:
- N/A
Primary Location: California,Harbor City,South Bay Medical Center Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Working Hours Start: 08:30 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee Job Level: Director/Senior Director Department: South Bay Med Center - Hosp Admin-Quality Leadership - 0801 Travel: No 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.