Program Manager V, Strategy Execution - National Medicaid Quality

Essential Responsibilities:

National Medicaid Model of Care

Coordinates project team to develop approach for Government Programs risk stratification

Prepares regular project status updates (ie. Medicaid Goals Update)

National Medicaid Quality Governance

Organizes forums for cross-regional Medicaid Quality collaboration (ie Regional Quality Medicaid leads, Regional Medicaid Medical Directors.)

Supports regional launch of Medicaid Quality governance structure (ie Government Programs Oversight Committee)

Collaborates closely with California-based team for National Medicaid Quality and Health Equity

Builds and maintains strong relationships with Medicaid quality leadership of all regions

Helps spread best practices in Medicaid quality governance and systems among regions

Prepares regular project status updates (ie. National Quality A3)

Data and Reporting

Creates a repository of Medicaid quality data from all regions; analyzes and escalates trends and issues of concern; understands improvement opportunities and health disparity trends

Collaborates with NMQHE team to analyze and prepare market level data for quarterly business report out

Contributes to development of an enterprise-wide strategy to optimize NCQA Medicaid ratings

Medicaid Behavioral Health Quality

In partnership with the Population Health Management Quality Strategy Lead, Care Delivery Operations, PMG and other relevant stakeholders, shape Kaiser Permanente's California Medi-Cal behavioral health quality strategy by establishing governance, reporting, measurement, and oversight frameworks that advance behavioral health outcomes and regulatory compliance

Provide Medicaid-specific leadership for behavioral health data-sharing initiatives, translating regulatory requirements into cross-functional implementation strategies, quality reporting capabilities, data governance processes, and operational execution plans.

Leadership Communications and Support

Builds repository of projects and presentations for NMQHE team

Helps organize presentations and dissemination activities for VP, Associate CMO Medicaid Quality and ED, Chief Health Equity Officer, National Medicaid

Supports NMQHE communication through dissemination with high level of skill and professionalism (powerpoint, written briefs and articles, etc)

Communicates NMQHE goals and strategies in a variety of forums (internal and external meetings, to partner teams in the organization)

Co-facilitates bi-monthly and bi-weekly internal team meetings; supports on-site agenda design

In addition to the responsibilities listed below, this technical functional leader is also responsible for managing strategic, enterprise-wide, cross-regional, and/or multi-disciplinary programs to drive exceptional business value for KP; managing evolving strategic priorities and providing strategic planning within and across programs to drive and ensure alignment and performance across the organization. This includes regularly monitoring the progress of initiatives across the program and proactively identifying risks and opportunities of strategic business value; raising visibility on critical issues to ensure effective resolution; and identifying, gathering and evaluating data and key performance drivers to understand strategy performance and any gaps. This position is also responsible for providing design plans and supporting the development and execution of change management strategies during key program or organizational changes and transitions; working in a variety of dynamic situations requiring exceptional consulting, internal influence, conflict management, and resource/team management; proactively conducting external research to identify and implement market leading practices; embracing a can-do strategic approach with sound business acumen; and advising and partnering with senior leaders while operating within a fast-paced environment.

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Manages large-scale programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability for achieving program outcomes from initiation to close-out in an extended or open ended time frame. Develops, analyzes, and manages highly complex program plans which include scope identification and management, schedule, inter-dependencies, and resource forecast. Manages and monitors the program financials of large-scale programs. Monitors program performance to ensure programs effectively deliver maximum long term value or benefit to the organization, and makes adjustments as needed in an uncertain environment where scope may be fluid. Leads program activities related to organizational change management (e.g., development and execution of user adoption, implementation, and training plans) as defined by the program. Drives allocation of resources, establishes schedules, and task assignments to ensure established program management practices are in place. This role may perform project management duties in addition to program management responsibilities.
• Leads the work of large program teams by monitoring internal and external resources. Leads others in requesting and coordinating internal and/ or external resources based on the alignment of team member skills and program demands. Communicates a clear vision of program goals and objectives to the team. Delivers performance feedback to team members supervisors.
• Proactively monitors, identifies, and mitigates program risks, issues, and trigger events by developing mitigation plans and strategies; and resolving or escalating risks or issues as appropriate.
• Monitors adherence of program activities to policies and procedures by ensuring program plans and team members follow KP, departmental, and/or business line policies and procedures.
• Ensures the alignment, buy-in, engagement and support of diverse program stakeholders by building and maintaining relationships as well as communicating appropriately with internal customers, third party vendors, senior management, and business leaders; and clarifying accountability and authority across stakeholders. Identifies and works closely with key stakeholders based on their level of influence and decision making and ensures all appropriate stakeholders are represented and included. Provides insight to key stakeholders and program sponsors by developing program goals, setting the prioritization of deliverables, discussing involvement of business processes (e.g. program change management, communication) and facilitating decisions necessary for program delivery. Communicates tough issues to stakeholders while maintaining an independent opinion, providing recommendations, delivering formal presentations, and providing reports to various senior audiences. Engages with senior stakeholders to identify long term value to the organization and define success.
• Reviews vendor performance levels and ensures service level agreements are met. Partners with Procurement and/or Legal to develop service level and/or scope of work agreements as appropriate. Participates in contract negotiations with vendors and reviews program invoices submitted by vendors for accuracy.