ED, Risk Adjustment Strategy & Transformation

Kaiser Permanente is seeking a transformational and enterprise-minded leader to serve as the Executive Director, Risk Adjustment Strategy & Transformation. This executive will partner with leaders across the Permanente Medical Groups, ICC, Health Plan, Revenue Cycle, Technology, Finance, and regional operations to translate enterprise objectives into measurable clinical, operational, and financial outcomes.

About the Role

Reporting to senior leadership within National Health Plan Risk Adjustment, this role serves as a key enterprise stakeholder and strategic partner in developing, governing, and evolving cross-functional initiatives that support clinical documentation excellence, coding accuracy, encounter data integrity, and value realization. The Executive Director will foster effective enterprise governance and stakeholder engagement, working through established structures like the Care Delivered, Value Captured, Unrivaled Experience (CDVCUE) Board to facilitate collaboration, alignment, and coordinated execution.

Success depends on bringing together diverse perspectives, building consensus, and creating alignment around enterprise priorities while respecting distinct roles and responsibilities. This leader will influence without direct authority, support stakeholder-driven solution design, and help establish sustainable adoption of strategic initiatives. The role also supports National Health Plan growth efforts, including enterprise capability assessment and integration activities like Kaiser Permanente Nevada (KPNV).

Responsibilities

• Lead the overall strategy, governance, operating model, implementation roadmap, and execution of the CDVCUE initiative, including establishing enterprise objectives, key milestones, success metrics, and accountability frameworks.
• Develop strong working relationships with executive leaders across National Health Plan, Permanente Medical Groups, Care Delivery, Technology, Revenue Cycle, Claims, Finance, Compliance, Legal, Consumer Experience, Scheduling, and Benefits Administration to align priorities and resolve cross-functional issues.
• Translate strategic objectives into executable implementation plans with defined workstreams, deliverables, dependencies, timelines, and resource requirements; monitor progress and drive accountability across matrixed teams.
• Oversee the design, development, testing, implementation, and operational integration of Clinical Full Kit, Scheduling Full Kit, Patient Encounter, and Submission Full Kit capabilities, ensuring scalability and standardization.
• Work with Finance, Risk Adjustment, Revenue Cycle, and business leaders to establish value realization targets, monitor operational and financial outcomes, and support reimbursement integrity and margin improvement.
• Partner with technology and operational leaders to identify opportunities for automation, workflow optimization, analytics, AI capabilities, and process redesign to improve care delivery, documentation, coding, and data submission.
• Collaborate with Legal, Compliance, Privacy, Internal Audit, and operational leaders to identify risks, implement controls, and ensure regulatory compliance and alignment with Kaiser Permanente policies.

Requirements

• Minimum eight (8) years of progressive leadership experience within healthcare, including health plans, integrated delivery systems, healthcare operations, population health, revenue cycle, risk adjustment, or related disciplines.
• Bachelor’s degree in healthcare administration, Health Policy, Business Administration, or a related field is required.
• Significant direct risk adjustment experience with demonstrated understanding of prospective and retrospective risk adjustment programs, documentation and coding operations, encounter data, value-based reimbursement, and regulatory requirements.
• Demonstrated success leading enterprise-wide transformation initiatives requiring coordination across multiple business units, markets, regions, and executive stakeholders.
• Experience creating and executing enterprise implementation roadmaps, governance structures, accountability frameworks, and organizational change strategies.
• Experience partnering with physician leaders, operational leaders, finance, technology, and executive teams to drive business outcomes and large-scale adoption of new capabilities.
• Experience developing executive-level presentations, business cases, strategic recommendations, implementation plans, and performance reporting for senior leaders.
• Experience leading highly matrixed organizations and driving results through influence rather than direct authority.

Preferred Qualifications

• Advanced degree (MBA, MHA, MPH, MS, or equivalent graduate degree).
• RN or another clinical certification.
• Certified risk adjustment coder certification or professional certifications in Program Management, Change Management, Lean, Six Sigma, Agile, Healthcare Operations, or Healthcare Technology.
• Three (3) years of healthcare consulting experience supporting large-scale strategic, operational, technology, or organizational transformation initiatives.
• Knowledge of integrated healthcare delivery systems, payer-provider models, and value-based care arrangements.

Schedule

• Full-time, standard schedule (Monday–Friday, 8:00 AM–5:00 PM).
• Travel: Yes, 15% of the time.
• Work Setting: Flexible (worker location must align with Kaiser Permanente's Authorized States policy).

Pay

The posted pay range is $256,500–$320,625 per year. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location. Kaiser Permanente strives to offer a market-competitive total rewards package and is committed to pay equity and transparency.