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Kaiser Permanente Careers

Quality Assurance, UR & Case Management

Passion + Vision + Integrity = Excellence

Ensure consistency and the highest ethical standards across our entire organization. Our quality assurance team drives ongoing improvement by fostering an environment of support, providing technical and specialized consultative services, and inspiring ongoing excellence.

Director, Post-Acute Utilization

Location: Rockville, MD Additional Locations:
Job Number: 780519 Date posted: 03/20/2019

Directs and coordinates the administration of continuum care services skilled nursing, home health, hospice, palliative care, dialysis, behavior health.  Primarily responsible for the development, planning, management and integration of operational support services across the continuum of care.

Essential Responsibilities:

  • Provides regionwide leadership, strategic direction and recommendations over areas of accountability. Directs and coordinates all administrative continuum of care services, including skilled nursing, home health, hospice, palliative care, dialysis, behavior health. Establishes and achieves long-range strategic plans, goals and objectives for continuum of care administrative operations for the areas of accountability. Defines and communicates strategic objectives and scope.

  • Achieves performance expectations for administrative areas of continuum of care resource management operations. Establishes standards of practice and monitoring of performance for continuum of care operations for the area of accountability including skilled nursing patient day rate (PDR), skilled nursing and home health readmission rates, and access.

  • Ensures consistency of process and program objectives across geographic areas, agencies and functional units by focusing team efforts in achieving a coherent, integrated whole. Creates the structure and processes to develop, implement and evaluate programs, policies and standards for areas of accountability to support continuum of care services delivery to improve quality, service and affordability/cost trends.

  • Coordinates with facility-based and regional resource management leadership to develop systems to ensure the seamless transition of patients to the continuum.

  • Develops strategic partnerships with external providers to improve quality, service, access and affordability/cost trends in continuum of care services.

    Basic Qualifications:


  • Minimum seven (7) years of utilization/resource management experience.

  • Minimum five (5) years of management experience in the health care industry.

  • Education

  • Bachelor's degree in nursing, health services, business administration, public health field 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:

  • Demonstrated strong interpersonal/communication skills.

  • Strong presentation, leadership, project management and consultative and problem-solving skills required.

  • Ability to lead and manage through influence and change.

  • Demonstrated ability to lead professionals through influence and collaboration.

  • Understanding of and experience in process improvement and the tools and data requirements for supporting an effective process

  • improvement practice.

  • Must exhibit efficiency, collaboration, candor, openness and results orientation.

  • Strong verbal and written communication skills and presentation skills required.

  • Decisiveness, action-orientation, personal integrity, capability to persevere in difficult situations and a focus on strategic leadership

  • issues highly desired.

  • Possess an open collaborative leadership style that promotes teamwork and partnership while achieving desired results.

  • Thorough knowledge of quality assurance, resource management, health plan regulatory and licensing processes including federal

  • and state laws and regulations.

    Demonstrated understanding of health policy trends and any applicable regulations.

  • Must be able to work in a Labor/Management Partnership environment.

  • Preferred Qualifications:

  • Experience working in a high level administrative capacity within multi-faceted health care system and multi-service provider setting preferred.

  • Understanding of the operations of KP preferred.

  • RN license in appropriate jurisdiction(s) preferred.

  • Master's degree preferred.
  • Primary Location: Maryland,Rockville,Rockville Regional Offices 2101 E. Jefferson St. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: Varies Working Hours End: Varies 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: QA / UR / Case Management Department: Continuum of Care Travel: Yes, 15 % 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.

    About QA, Ur & Case Management Careers

    Careers In QA, Ur & Case Management

    As an organization, we are committed to delivering the same exemplary care no matter who you are, where you are, or what your needs. But how are those standards defined, measured, and assessed? That's where our quality assurance team comes in. Implementing the action plans and initiatives that will drive successful practices, you'll work across the organization to foster the necessary education, communication, and innovation that will enable us to operate as one KP — with our mission and goals in complete alignment.

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