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Kaiser Permanente Careers

Communication & Public Affairs

Drive Our Reputation

We need our brand to stand out from the crowd, and our communications gurus make this possible. They are geniuses behind the bold, positive, and unique Kaiser Permanente brand. We need to add more outstanding public affairs experts to our exciting team to unleash their creativity and ensure our company's reputation accurately reflects the outstanding work we do.

Medicaid Business Strategic Consultant

Location: Portland, OR Job Number: 886949 Date posted: 09/08/2020

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Description:
The Medicaid Business Strategic Consultant will have active participation in a range of strategic initiatives essential to KP's Medicaid and Charitable program membership, regional margin goals and mission. The Strategic Consultant will oversee Medicaid contracting strategy, and serve as a subject matter expert for KPNW, Medicaid contracts and operations. The Strategic Consultant will provide analytical/strategic thinking, technical/content expertise and leadership skills in order to make formal recommendations to senior leadership. This role will manage relationships with multiple internal departments and external business partners to ensure Kaiser Permanente meets its contractual obligations and requirements, in addition to playing a leadership role in addressing Medicaid regulatory requirements.

Essential Responsibilities:
  • Negotiate, implement and oversee Medicaid contract management and operations ensuring compliance with all provisions contained within each agreement: develop reports, create solutions to internal challenges, prepare for audits, implement and operationalize changes as dictated by Oregon Health Plan, Health Care Authority of WA, and Centers for Medicare/Medicaid Services.
  • Build partnerships with internal departments and provide strategic consultation on Medicaid and charitable coverage programs: work with regional leadership and functional partners in quality, patient financial services, local coordination of benefits team, national claims administration, compliance and other regional and national shared services. Support data analytics team to manage encounter data and pends, support Health Plan on issues related to provider enrollment, internal coordination of benefits teams to implement Medicaid and charitable coverage Products. Manage business development opportunities including expansion to new markets and new business partners.
  • Support strategic market planning and financial planning and analytics activities for Medicaid Line of Business including rate setting, operational business planning, and administrative budget planning.
  • Manage relationships with community partners, including safety net clinics, access to care programs and other charitable organizations that provide access to health care for underserved populations. Work with community stakeholders to ensure a strong flow of information, informing strategic planning related to health outcomes and tracking and reporting on community health investments and programs related to the Community Benefit Community Health Needs Assessment (CHNA) and Implementation Strategies process.
  • Basic Qualifications:
    Experience
  • Minimum (5) Five years of progressive experience in healthcare or Health Insurance administration.
  • Minimum (4) Four years of state Medicaid experience including developing, managing and evaluating Medicaid contracts, policies, benefits, and reporting.
  • Minimum (4) Four years of management of complex projects, preferably in a health care, health insurance or community health setting.
  • Education
  • Bachelor's degree in business, public health, health care administration, OR four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.
  • License, Certification, Registration
  • N/A

  • Additional Requirements:
  • Strong written and verbal communication skills.
  • Knowledge of healthcare operations and community health issues related to Medicaid populations.
  • Ability to understand and utilize data to improve performance.
  • Must be able to work in a Labor/Management Partnership environment.
  • Strong project management and consulting skills
  • Demonstrated ability to interpret quantitative and qualitative analyses and to communicate these to non-technical audiences.
  • Demonstrated ability to create partnerships across disciplines and departments and foster positive communication and working relationships to achieve shared goals.
  • Proficiency with Microsoft Office Suite: Outlook, Word, Power Point, Excel
  • Ability to synthesize a variety of data to produce a cohesive and well-documented report.

  • Preferred Qualifications:
  • Five (5) of more year's progressive experience in operational or technical areas related to healthcare services, benefits and policies.
  • Five (5) or more years of state Medicaid experience including developing, managing and evaluating Medicaid contracts, policies, benefits, and reporting.
  • Five (5) or more years of management of complex projects, preferably in a health care, health insurance or community health setting.
  • Master's degree in public health, public policy, health care, public administration, business or related field
  • Preferred by not required:
  • Familiarity with Kaiser Permanente operations and planning processes.
  • Primary Location: Oregon,Portland,Kaiser Permanente Building 500 NE Multnomah St. 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: Individual Contributor Job Category: External Affairs / Relations Department: Medicaid and Charitable Programs Travel: Yes, 5 % of the Time 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.

    Learn About Communications Careers

    Careers In Communications

    Communications combines numerous interrelated departments dedicated to advancing the Kaiser Permanente mission, promoting and protecting the Kaiser Permanente brand, and supporting the success of its strategy, including Corporate Communications, Issues and Brand Management, Public Relations, Media and Stakeholder Relations, Public Affairs, and more — both internally and externally.

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