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Health Care & Hospital Operations

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Executive Director of Contract Management, Medi-Cal

Location: Oakland, CA Additional Locations:

Regional Offices-Walnut 393 E. Walnut St., 393 E. Walnut St., Pasadena,California, 91188
Job Number: 764177 Date posted: 01/08/2019
Description:


The Executive Director of Contract Management provides leadership, strategy, and direction setting to support the contracting function of the Medi-Cal line of business for California; co-leads or leads statewide and regional strategic initiatives; and participates as a member of the National Medicaid Community of Practice. This Executive Director will: Drive strategy and execution of Medi-Cal Health Plan Administration contract management functions and processes for DHCS, and California Plan Partners. This contract management supports the business imperatives of the California regions as they relate to the communities we serve, our members, and our workforce; Partner with key leaders in Regional Medi-Cal Strategy and Operations and other Medi-Cal stakeholders to ensure alignment of health plan operations, care delivery, policies, and regulatory requirements; and Lead the strategy, development, negotiation, and implementation of significant Regional Medi-Cal Plan Partner/DHCS contracting initiatives, including improved review, approval, and signature process.



Essential Responsibilities:
- Servicing California Statewide stakeholders responsible for communications, assessments, identifying network needs, strategy development, financial, implementation, forecasting, etc. Developing strategy and leads overall responsibilities for establishing and managing stakeholder relationships.
- Serving as the primary liaison between Kaiser Permanente CA Medi-Cal Programs and Plan Partners to support financial reporting and data analysis related to existing contracts, amendments, and/or ongoing contract negotiations.
- As necessary, identifying qualified vendors to augment Kaiser Permanente-s network of non-medical services for targeted member populations. When a vendor is engaged, the Director will lead the development of associated contracts, vendor management, and oversight to ensure Kaiser Permanente-s quality and resource standards are met or exceeded by our community partners.
- Overseeing the development, negotiation, implementation, tracking and analysis of Medi-Cal Plan Partners and DHCS contract improvement initiatives and related metrics for assessing contract performance.
- Leading and coordinating relevant health plan, hospital, and medical group personnel to support contract strategy negotiation, implementation, and performance improvement metrics.
- Building a focused, coordinated effort to build and promote Kaiser Permanente-s brand and reputation through collaboration with California, SCPMG, TPMG, local Medical Centers and other KP departments.
- Working closely with the VP of California Medi-Cal, and executive leadership to develop quality improvement and cost savings initiatives to ensure cross-functional integration and coordination of efforts.
- Conducting region-specific budget preparation and policy and program implementation of federal and state initiatives.
- Making health plan adjustments to guarantee that Medi-Cal contracts are performing at or exceeding set targets.
- Working closely with California Medi-Cal leaders to ensure that health plan operations and care delivery programs for California are intimately aligned with Medi-Cal administrative health plan functions, including but not limited to DHCS All Plan Letter implementation, compliance, audits, and contract administration.
- Establishing strategy to meet federal and state regulatory contracting requirements in partnership with key stakeholders such as National and Regional Provider Contracting, Medi-Cal, Medicare, Regional government programs, and Health Plan Regulatory Services.
- Ensuring detailed understanding of contract performance for the Medi-Cal business line, and building relationships with our communities to help differentiate KP and strengthen our reputation as a health plan.
- Other duties as assigned by the California Vice President of Medi-Cal, CHIP, and Charitable Care.

Basic Qualifications:
Experience
- Minimum ten (10) years of relevant experience in healthcare, including leadership and management experience in health plan, hospital, medical group administration, Medicaid/Medi-Cal and government programs.
Education
- Bachelor-s degree required
License, Certification, Registration
- N/A.

Additional Requirements:
- Demonstrated ability to build consensus on strategies among leaders/peers/staff and across different reporting structures and entities. Able to drive executive teams and multidisciplinary groups.
- Demonstrated ability to lead significant organizational change initiatives and be strong representative/sponsor both externally and internally.
- Excellent interpersonal skills (negotiation, presentation, public speaking, listening and communication skills) characterized by effective interactions and strong working relationships with a diverse range of internal and external constituents, stakeholders and audiences.
- Experience in developing and implementing strategic plans, with particular interest/emphasis in Medicaid/Medi-Cal and State Programs.
- Ability to build and maintain relationships with external governments agencies, clients and plan partners.
- Deep knowledge of overall health plan functions, including operations, contracting, finance, public affairs, care delivery, member services, community benefit, public affairs, claims, quality management and related regulatory services.
- Strong business acumen with excellent strategic and analytical thinking capacity.
- Demonstrated strong program and project management skills and implementation expertise
- Demonstrated success in developing strong, collaborative relationships with key leaders to achieve goals.
- Expert understanding and the ability to demonstrate knowledge of federal and state health care laws, regulations affecting physician and non-physician practice, facility operations, health plan administration, political processes and legislative activity, financing and administration.
- Drives work through strong leadership, influencing skills and strong healthcare knowledge.
- Must be able to work in a Labor/Management Partnership environment.


 


Preferred Qualifications:
- Master-s degree in Business/ Finance/Economics/ Health Care Administration or related field is preferred.

Primary Location: California,Oakland,1800 Harrison 1800 Harrison 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: Director/Senior Director Job Category: Healthcare / Hospital Operations Department: Medi-Cal Travel: Yes, 25 % of the Time

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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