VP, Health Plan IT Strategy and Planning

The KP Health Plan relies on a complex portfolio of transactional and analytical systems to support its day-to-day activities across the 8 regions.  These systems range from broad multi-regional membership and claims systems to relatively small regionally specific solutions and from relatively low levels of complexity to systems pushing the limits of current architectures such as the National Pricing System. Overall the Health Plan portfolio represents an investment in the range of 3 plus billion dollars with a continuing annual investment in the range of $300 to $400 million dollars per year. This position leads the overall design, documentation and analysis of the business architectures for the key systems and portfolios of systems that constitute the Health Plan’s delivery capability. The incumbent works closely with all aspects and portfolios of the KPIT organization, the Health Plan PAC and its sub-committees and other internal business systems groups to assure consistency in approach, coordinate work and to serve as a resource for their initiatives. A primary responsibility for this role is the development, maintenance and continuous refinement of our multi-year information technology strategy and architecture in response to the evolution of our business, regulatory requirements, market demands, technology opportunities and KPIT strategy. Additionally, the position provides key sponsorship and leadership for complex IT strategy and implementation programs.

• Lead Health Plan Data Strategy.  Chair Health Plan PAC Sub-committee whose membership includes 6 SVP and 8 VP participants.  Align data strategy across the health plan and represent the health plan in enterprise-wide data discussions and initiatives.  Lead the strategy and planning, road map development, and investment project execution for Claims Data Warehouse, Benefit Data Warehouse, Member Month Mart and Membership Data Warehouse.  In conjunction with the Chief Data Officer, lead the strategy and planning for evolving data domains including provider, broker, Consumer Data Platform, and the sales data warehouse. Lead the business operational support teams managing these complex warehouses.  Drive adoption and usage of key data assets across the health plan and other KP areas such as Clinical, Finance, Actuarial, Underwriting and Decision Support. Establish National Data Governance practices.  Establish and maintain SOX controls for the Claims Data Warehouse and Membership Data Warehouse and all new formal data repositories requiring SOX certification.


• Lead Evidence Based Marketing Systems and Solutions.  Lead roadmap development, investment project work and business operations support for Marketing Analytics and Campaign Management, Marketing Business Process Automation and Management, Enterprise Profiles and Preferences, and the Marketing Digital Asset Management Solution.  Build and maintain relationships with Marketing leadership including the SVP, 4 marketing VPs, and regional marketing leadership.  Build and maintain relationships with KPIF and Medicare Line of Business leadership and their direct marketing initiatives. Lead the use and expansion of the Consumer Data Platform and Enterprise Profiles and Preferences.


• Lead Health Engagement Platform Solutions. Responsible for the technical platform and its migration in support of the Health Engagement Solutions.


• Lead Key Investment Programs.  Provide leadership, sponsorship and guidance to steering committees for key initiatives and Mega programs. Responsible for the success of small to medium initiatives and a key contributor to the success of large and mega programs. Oversee the broad integration and architecture of between 40 and 50 inflight initiatives annually.


• Serve as the Accountable Executive or Co-Accountable Executive for Major Health Plan System replacements.  This currently includesco- leading the strategy, planning, and program development for the membership systems consolidation and modernization a multi-billion dollar initiative. 


• Responsible for the Business Integration Strategy and Architecture of New Acquisitions for the Health Plan. Build and deliver integrated roadmaps for the integration of new KP acquisitions onto KP systems in support of shared services and other delivery objectives.  Develop alignment across top MSSA leaders and key IT and operational leaders in the new entity. Support entities formed under Risant. 


• Aligns IT Strategy with Business Strategies and Architectures.  As a key leader in the HP IT Strategy organization, leads the work to define KP’s Health Plan system architectures to support both the near term and longer range goals of the program.  This includes the assessment of existing and future IT investment as to the underlying systems and their fit with the Health Plans needs and objectives.   


• Establish and Maintain Destination Architectures for Key Health Plan Portfolios. Lead efforts with each HP PAC subcommittee to establish, refine and maintain destination architectures for the key business systems in their portfolio. This work is in conjunction with KPIT and key business leaders and maintains the currency of our architecture and capabilities across the evolution of our marketplaces, regulatory environment, capability requirements and the opportunities presented by the evolution of technology and KPIT’s strategy.


• Provide an Integrated View of the Health Plan Systems and Capabilities. Integrate plans and findings for all capability areas into an overall Health Plan architecture document. This document becomes the key roadmap for future Health Plan IT investments.


• Develop and Promote an Architecture Based View of our $3B+ portfolio of IT investments.  The Health Plan has and will continue to make significant investments in IT capabilities. The overall effectiveness of these investments is directly related to the quality and integrated view of the fundamental architectures represented in the portfolio. 


• Contribute to the effectiveness of IT-related programs and projects.  For large, complex or strategic project, support Realization Team Leaders in increasing effectiveness of our Qualified Idea, and Concept work.  Participate in evaluating design alternatives around core Health Plan functionality.


• Serve on the AI/ML Council. Provide architectural and technical support to the AI/ML Council as a voting member. Help drive the adoption of AI/ML techniques across the Health Plan Organization.