Kaiser Permanente · 1 month ago
Executive Director, Member & Volunteer Services-NCAL Market
Pleasanton, CA
Full-time
Onsite
Director/Executive
10+ years expKaiser Permanente is seeking an Executive Director for Member & Volunteer Services in the NCAL Market. This strategic leadership role focuses on enhancing member and volunteer experiences through operational excellence, innovative service frameworks, and collaboration with regional teams.
Health CareHospitalMental HealthNon ProfitPersonal Health
Responsibilities
Direct and provide strategic and operational leadership for Member Services and Volunteer Services across Northern California
Facilitate the provision of health plan services for members and prospective members through face-to-face contact. This includes addressing member inquiries, requests for assistance, complaints and grievances related to services and clinical care received, claims, sales, enrollments, as well as general billing and eligibility questions
Provide strategic direction and input to establish and implement national standards of performance for customer service delivery and quality, and to ensure mechanisms are in place to exceed member, purchaser and regulator expectations. Interface with executives within Volunteer Services and Member Services across all regions to understand the current standards and reach agreement on optimal, legal and contract compliant standards of performance around customer service delivery and quality. Secondly, through direct reports ensure that the operational infrastructure is in place to meet these standards
Collaborate and partner with regional leadership including Physician in Chief, Medical Group Administrators, Area Managers, Area Compliance, Area Quality Leaders, Revenue Cycle leaders to support Regional Member Experience and process improvement initiatives, leveraging the Volunteer Services and Member Services organizations and national leadership teams
Partner across functional areas and Regions to enhance customer service, operational excellence, workforce and culture development, performance metrics and goal setting
Educate and engage with regional medical group administrators from different service lines to influence, demonstrate value and achieve buy in for service and process improvement opportunities identified from Member Patient Satisfaction scores, Complaints and Grievance reports, Voice of the Member data, Member Concern Committee-s and Operational Leadership Feedback to streamline operations, enhance the member experience and reduce costs
Provide strategic guidance and leadership in negotiating, drafting, and managing Service Level Agreements (SLAs) that establish operating agreements/procedures with internal and external stakeholders and customers. Internal SLAs are negotiated with other MS&PI ED-s and VP-s, through determining perspectives and opportunities and agreeing on standards to set boundaries. External SLAs are with vendors, for example, customer service feedback survey vendors and are determined through setting parameters and determining contract specifications. Effectively monitor SLAs to ensure performance standards are met
Promote an environment focused on creating value for Kaiser members and patients. Partner with leaders and stakeholders across the enterprise to create/execute strategies and service improvement initiatives aimed at delivering the optimal member experience
Providing leadership to director led teams to establish and optimize overall service, quality and timeliness metrics and address issues proactively. Utilize survey data to establish baselines and improvement standards
Interact with purchasers such as employee purchaser groups to provide them with information about KP-s member service program. Provide similar information for use of Regulator liaisons
Educate and actively partner with staff and stakeholders including the Medical Groups, Health Plan and Hospital Executive/Leadership teams, on member issues and trends, and opportunities to increase member satisfaction
Create and deliver presentations around Volunteer and Member Services- operations, regional and local trends and opportunities, and Member Services- vision and objectives to staff and customers, including Senior Executives locally and regionally
Develop and adhere to budgetary plans (forecasting impact to budget, managing against actuals, reporting out on variances, etc.). Manage to service and quality goals within established regional budgets while ensuring operational alignment with KP affordability strategy
Develop service plans through goal setting process and adhere to quality plans provided by CAMS Quality and Risk
Manage service and quality goals within established regional budgets while ensuring operational alignment with KP affordability strategy. Identify opportunities for cost reductions; initiate actions to realize these opportunities
Ensure that performance management and staff development programs are in place and that succession plans are developed. Oversee the work of the Directors to help them identify, plan and develop strategies and activities to support current and future departmental competencies. Develop recommendations that support these requirements, prioritize initiatives and assign resources to ensure implementation
Drive the decision-making change and implementation of Member Service improvements with national impact, in partnership and collaboration with other regional leaders
Lead efforts to optimize members- experience through initiatives, customer service and advocacy
Identify, recommend and implement national strategies for standardization and efficiency
Lead, facilitate and contribute to regional committees/sub-committees/forums that address member satisfaction and service delivery; member due process with the functional areas of complaints, grievances and/or appeals; action plans and initiatives across the region to improve the member experience
Ensure appropriate staffing levels and contingency plans for business operations continuity, including necessary hiring/recruiting and workforce planning across all levels
Qualification
Required
Minimum ten (10) or more years of progressive leadership experience with large operational organizations
Bachelor-s degree or equivalent in Health Care Administration, Business, Management, Public Health Administration, or other Humanities, Science, or Business-related field required
General or specialized knowledge of U.S. Health Care industry including services; hospital, health plan and business operations; care delivery; health plan benefits and eligibility; other medical and charitable/state programs
A clear understanding of industry trends and best practices in the Health Care Delivery, Operations, and Benefits markets, and the ability to define business strategy and direction
Demonstrated ability to lead, collaborate, communicate, influence and partner effectively with senior and executive leadership and a broad cross section of business and functional leadership
Prior experience demonstrates leadership in developing strategic initiatives and driving change across very large, decentralized organizations
Clear and effective written, verbal and communication skills. Ability to clearly and quickly communicate complex subjects and issues to a broad range of audiences
Demonstrated competency in the areas of change management, influencing others, negotiation skills, staff development, coaching and motivation
Prior Strategic planning and business management/consulting experience
Preferred
Management experience in a health care setting preferred
Company
Kaiser Permanente
Kaiser Permanente is a health organization that offers disease prevention, mental healthcare, and chronic disease management services.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$7.48M2018-07-17Grant· $0.08M
2014-08-05Grant· $7.4M
Leadership Team
Gregory Adams
Chair and Chief Executive Officer
James L. Robinson III
Senior Vice President/Area Manager
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