Emerging Markets - Physician Leader

Leading as one, the Emerging Markets Physician Leader will collaborate closely with the Emerging Markets President and Health Plan Leader to ensure that the health and healthcare needs of members and patients in a new integrated care and coverage market are met through joint oversight for critical functions inclusive of access, quality, service, and affordability. The Emerging Markets Physician Leader will report to the CEO of KPMF.

This Emerging Markets Physician Leader will work collaboratively with various stakeholders to implement governance structures that establish norms, enhance the quality of care, optimize resource utilization, and foster a collaborative, trust-based culture among the physician and advanced practice provider workforce. The Emerging Markets Physician Leader is also responsible for ensuring the integrity and alignment of clinical practices with KP’s Ambulatory Strategy and industry standards to achieve the highest experience for members.

• Establish Physician Organization:
  
  
  
  • Develop a new KP physician organization and implement strategic recruitment initiatives to attract top-tier physicians and other clinical talent that aligns with KP’s mission and values.
  
  
  • Collaborate with KP Medical Foundation human resources and departmental leaders to create a comprehensive onboarding process that integrates new clinicians into the organizational culture.
  
  
  • Foster a sustained, engaged, and committed physician and APP workforce by promoting professional development opportunities, mentorship programs, and a supportive work environment.
  
  
  • Conduct regular assessments of workforce needs with the KP Medical Foundation and implement strategies to address gaps in physician and APP staffing, services and expertise.
  
  
  
  


• Strategic Partnerships
  
  
  
  • Lead the development and maintenance of partnerships with key strategic partners.
  
  
  • Form and influence relationships that align care delivery objectives and support market initiatives.
  
  
  • Establish robust governance structures to facilitate collaboration and accountability among partners.
  
  
  
  


• Operations: Quality
  
  
  
  • Ensure compliance with KP Medical Foundation standards by establishing and monitoring quality metrics and performance indicators.
  
  
  • Lead initiatives to improve clinical outcomes, patient safety, and overall quality of care through evidence-based practices and continuous quality improvement processes.
  
  
  • Collaborate with clinical teams to develop and implement best practices and protocols that enhance patient care and align with organizational goals.
  
  
  • Conduct regular reviews of clinical performance data and implement corrective actions as necessary to address areas of concern.
  
  
  • Produce superior quality measures (NCQA accreditations, HEDIS, etc.) resulting in local reputation of excellence among providers and the public and high rankings compared with other health plans (upper decile to upper quartile in nearly all credible and public reported surveys) 
  
  
  • Planning/Goal Setting: Is always aware of trends in the industry and maintains regular dialogue amongst their staff on current performance and future expectations. 
  
  
  
  


• Operations: Service Delivery Across Ambulatory Care Settings
  
  
  
  • Lead achievement of clinical goals that drive the business case performance e.g., utilization management, care management, member satisfaction, member access
  
  
  • Develop and implement strategies to improve service delivery across all care settings, focusing on member engagement and satisfaction.
  
  
  • Utilize patient feedback and satisfaction surveys to identify areas for improvement and implement targeted interventions.
  
  
  • Collaborate with interdisciplinary teams to streamline care processes, reduce wait times, and enhance the overall patient experience.
  
  
  • Promote the use of enabling technology and innovative care models (e.g., using the right care, right time, right place framework) to improve access to care and enhance member engagement.
  
  
  
  


• Utilization Management:
  
  
  
  • Oversee utilization management processes to optimize healthcare resource use while maintaining high-quality care standards e.g., appropriateness of care, reducing care delays
  
  
  • Analyze utilization data to identify trends, opportunities for improvement, and areas of potential cost savings 
  
  
  • Collaborate with clinical teams to develop guidelines and protocols that promote appropriate resource utilization and reduce unnecessary procedures.
  
  
  • Ensure that utilization management practices align with organizational goals and regulatory requirements.
  
  
  • Resource Management: Meet short- and medium-term growth targets. Ensure adequate infrastructure (providers, staff, information systems, administrative capability, external networking) to meet operational goals
  
  
  • Aligns various parties to deliver superior utilization profiles (upper quartile in appropriateness compared with other managed care organizations) in hospital-based, “Alternate” (HHC, SNF, etc.) and ambulatory care.
  
  
  
  


• Effective Delivery of Professional Services:
  
  
  
  • Collaborate with contract management teams to define member outcomes and performance metrics in professional services contracts.
  
  
  • Monitor the delivery of professional services to ensure compliance with contractual obligations and quality standards.
  
  
  • Implement performance improvement initiatives to enhance the effectiveness and efficiency of professional services.
  
  
  • Foster strong relationships with external stakeholders, including payers and community organizations, to enhance service delivery and member outcomes
  
  
  
  


• Behaviors (Human Capital / Human Capital Management):
  
  
  
  • Role Modeling: Demonstrates commitment to pre-eminence, partnership, Principles of Medical Practice, and leadership through strategic planning, management style and decisions, personnel decisions, and written and oral communications. 
  
  
  • Advocacy: Uses judgment about when to become actively involved in specific decisions or disputes. Advocates primarily for the success of medical groups and the market and for individual groups or activities when appropriate.
  
  
  • Personnel Management: Selects excellent direct reports who work well together as members of a “team.”
  
  
  • Staff Development and Mentoring: Molds positions to meet the needs of medical groups and the particular capabilities of current staff. Uses annual performance appraisal and regular meetings to highlight areas for improvement and opportunities for development and/or promotion. Scans the KP and external environment for formal courses or workshops of potential value to direct reports. Promotes education and training for all physicians regarding new trends and issues of interest to our profession.
  
  
  • Communications: Is a good listener and communicates well in many settings. Is always aware of what issues are of most importance to  constituents and models the axiom “you can never communicate too much (to members of a large organization).” Is especially attentive to professional pressures and stresses in medical groups and communicates concern, and medical group efforts on their behalf, to our physicians
  
  
  
  


• Administrative Proficiency
  
  
  
  • Knowledge: Seeks to maintain knowledge of major advances in the practice of medicine and within the specialty area. Enhances administrative knowledge through attendance at external conferences, educational seminars and involvement in professional association activities 
  
  
  • Professional Respect: Possesses high professional standards and maintains respect of physician colleagues. Is regarded by other physicians as a physician able to demonstrate understanding of the changing medical environment such as medical/legal issues, staff concerns, customer demands, sensitivity to timing, etc.