Senior Director Regional Member Services

About the role

The Senior Director of Member Services leads regional operations that deliver highly responsive, proactive engagement for members and patients across multiple service areas. This role drives key initiatives that strengthen retention, support Medicare 5-Star performance, reduce experience friction, and increase likelihood to recommend Kaiser Permanente.

Responsibilities

• Provides strategy and direction to the Member Services function across the NCAL or SCAL region.
• Develops and executes strategic plans, policies and objectives with long term, region wide impact to the Member Services function.
• Establishes and executes goals and processes.
• Identifies and drives internal initiatives to improve overall quality performance in Member Services.
• Has region wide control of the planning, staffing, budgeting, managing expense priorities, and performance requirements.
• Oversees the day to day operations in the local medical centers throughout the region to ensure member satisfaction and compliance with ongoing regulatory requirements.
• Manages programs to ensure survey readiness for the Member Services function.
• PARTNERS WITH LEADERS IN THE LOCAL MEDICAL CENTERS TO ENSURE THE IMPLEMENTATION OF COMPLAINT RESOLUTION PROCESSES AND PROCEDURES IN THE MEDICAL CENTERS BOTH AT THE REGION WIDE OR LOCAL LEVELS.
• WORKS WITH PEERS FROM MEMBER SERVICES AND MEMBER CORRESPONDENCE CENTER IN ENSUREING INTEGRATION OF THE MAJOR COMPONENTS OF STATEWIDE AND NATIONAL SHARE SUPPORT OPERATIONS.
• OVERSEES KEY OPERATIONAL RELATIONSHIPS BETWEEN NCAL AND SCPMG IN EFFORTS TO ACHIEVE QUALITY OUTCOMES AND MAINTAIN ONGOING REGULATORY COMPLIANCE.
• DEVELOPS AND EXECUTES BEST PRACTICES FOR PERFORMANCE MEASUREMENT.
• PARTNERS WITH EXECUTIVES FROM NCAL KFH/HP, TPMG AND SCPMG TO ENSURE LEVERAGING OF CAPABILITIES AND SHARING OF STATEWIDE BEST PRACTICES.
• COLLABORATES WITH SALES, MARKETING AND MEDICAL CENTER LEADERS TO IMPROVE MEMBER RETENTION, AFFECT GROWTH AND IMPROVE PURCHASED GROUP SATISFACTION.

  Requirements

  Basic Qualifications:

  • Minimum seven (7) years senior management/leadership experience in health care managing multiple locations.
  • Minimum five (5) years of experience in a complex healthcare (HMO) environment.
  • Bachelor's degree in Health Care Administration, Business or Public Health Administration, Operations Research, Economics or other related field, OR four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.

  Qualifications

  • Proven ability to lead and manage through influence and change; implementing strategic changes.
  • Proven capability to motivate change and galvanize action through synthesis and interpretation of outcome data.
  • Demonstrated background in strategic thinking and implementation.
  • Proven ability to balance execution of the strategic vision through leadership and delegation, with a willingness and competence to dive into the details as required.
  • In-depth knowledge of, and leadership experience with, KP Program requirements for NCQA Accreditation and regulatory compliance.
  • Leadership experience working with regulatory agencies and dealing with integrated care delivery systems and coordinated care issues.
  • Successful experience managing a broad range of operational and organizational redesign, improving internal operations, financial turnaround, creating a performance oriented organization, and change management.
  • Demonstrated expertise in project management, problem solving, verbal and written communication and collaborative working skills.
  • Excellent interpersonal skills (negotiation, listening and communication skills) characterized by effective interactions with a diverse range of internal and external constituents, stakeholders and audiences.
  • Demonstrated political savvy -- able to operate in politically complex situations and remain effective.
  • Demonstrated ability to function collaboratively in a multi-entity partnership environment.
  • Demonstrated leadership capabilities, including but not limited to developing dynamic, constructive working relationships and partnerships with operational, physician and administrative Leaders.
  • Proven ability to develop dynamic, constructive working relationships and partnerships with operations and physician partners.