Kaiser Permanente Northwest
Vice President, Quality & Safety - Northwest Market
Kaiser Permanente Northwest, Portland, Oregon, United States, 97204
Overview
The person in this position will provide the strategic leadership for Kaiser Foundation Health Plan to compete as the quality leader in health care. On behalf of the Health Plan, the individual in this role has the overall responsibility for ensuring the quality, safety, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system. This leader partners with the market Permanente Medical Group to ensure care delivery strategies meet regulatory and accreditation compliance; aligns with national and market policies and programs related to quality and safety; and establishes/oversees quality management systems and governance. The role functions on behalf of the KFHP/H Board of Directors to provide effective quality oversight of both facility and provider credentialing. It also proactively collaborates with key Health Plan and physician leaders across the national system to support the delivery of high quality, cost-effective, integrated healthcare to members and patients. Core work includes the development and implementation of strategic quality and safety oversight objectives, quality oversight programs and corrective action plans for continuous quality improvement, and the development and monitoring of measures for safe, timely, effective, efficient, equitable, and person-centered care.
It supports compliance and the Principles of Responsibility by maintaining privacy, protecting assets, acting with ethics and integrity, reporting non-compliance, and adhering to applicable laws, regulations, accreditation and licensure requirements, and Kaiser Permanente policies and procedures. Essential Responsibilities
Directs a high functioning team of quality and safety professionals who oversee quality, safety, infection prevention, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system. Partners with Permanente Quality to provide overall leadership of the KP market’s quality of care program for the delivery system including ambulatory, inpatient, dental, continuing care services as well as contracted hospitals and network providers. Partners with the Hospital Administrator(s) to provide leadership and oversight of the Hospital Quality program, ensuring activities are in alignment with, approved, and directed by the Board of Directors (QHIC). Drives, and when appropriate, partners with market PMG quality and/or operational leaders in the development of quality oversight programs and systems that position Kaiser Permanente as the quality leader in the marketplace through participation in externally benchmarked measurement programs (e.g., HEDIS, CMS 5 Star, NCQA, Patient-Centered Medical Home, Leapfrog). Identifies obstacles, barriers, and issues impacting the KP market’s ability to meet its quality, workplace safety, patient safety, clinical risk management and regulatory goals and objectives. Represents the KP market in strategic matters locally and nationally, relating to issues of clinical quality, service quality, safety, and risk (e.g., market quality oversight committees, KPNQC, SERCIT, Board of Directors). Collaborates with national functions (e.g., Care Management Institute, IRPMO) and other units to obtain ongoing data on quality outcomes and member/community health status improvements. Leads Quality Program Administration, including quality management oversight, health care delivery oversight, assessment, and intervention. Supports Population Health Community of Practice to develop strategic prevention plans, implement program guidelines, and evaluate outcomes for members’ health using HEDIS targets and outcomes. Partners with care delivery leaders by providing timely and accurate quality and regulatory advice, information, consultation and measuring satisfaction of accountable services. Collaborates with Compliance and operations to minimize clinical risk and maximize quality outcomes. Ensures Accreditation, Regulatory Compliance and Licensing as appropriate. Directs activities to ensure that the KP market obtains and maintains full NCQA accreditation and meets CMS, state, and other regulatory requirements (examples include Medicare 5-star, Joint Commission, Det Norske Veritas, American Heart Association). Ensures effective execution of business strategies by aligning human resource strategies with business needs, recruiting and developing a high-performance team, and creating a climate that builds employee commitment and reinforces performance, customer service and quality outcomes. Contributes to and utilizes national strategies and capabilities; promotes sharing of new learnings and innovations. Develops and implements an approach to quality and licensing/regulatory services that integrates strategy with day-to-day operations. Provides interface between Health Plan and the market Permanente Medical Group for a variety of initiatives including quality and safety oversight. Drives internal initiatives to improve overall performance by addressing unreliable, poorly controlled, ineffective, inconsistent, and duplicative processes. Builds and maintains responsive, motivated, and efficient departments that ensure results orientation. Qualifications
Experience
Minimum eight (8) years management experience, with a minimum of five years in healthcare operations. Education
Master’s degree required. License, Certification, Registration
Registered Nurse License (from any state) required at hire OR Pharmacist License (from any state) required at hire Pharmacist License (Oregon) within 3 months of hire OR Registered Nurse License (Oregon) within 3 months of hire Additional Requirements
Service Orientation: Develops long-term strategies to enhance member/customer satisfaction. Listening: Understands stakeholder needs and concerns into effective programs. Integrated Thinking: Synthesizes varied viewpoints and priorities. Communication: Tailors communication to engage audiences and translate strategy into action. Influence: Builds program-wide relationships to move initiatives forward. Team Focus: Fosters collaboration and adapts management style for team performance. Change Leadership: Manages long-term change with a clear roadmap. Decisiveness: Makes informed decisions addressing key threats and opportunities. Results Orientation: Tracks results against external benchmarks. Cultural Competence: Serves diverse local populations. Develops Others: Coaches and mentors future leaders. Personal Development: Seeks challenging opportunities to meet development needs. Knowledge of quality oversight, accreditation, and regulatory compliance for Health Plan hospital and medical group. Leadership experience with regulatory agencies and integrated care delivery systems. Analytical and problem-solving skills; ability to motivate change through data interpretation. Ability to balance strategic vision with day-to-day operations; build partnerships with physician and labor groups. Willingness to challenge the status quo and act as a risk taker. Excellent interpersonal, negotiation, listening, and communication skills with diverse stakeholders. Strategic/Systems Thinking (3+ years): ability to formulate unit strategy. Preferred Qualifications
Graduate degree in business administration, nursing, or health care administration is preferred. Current RN license preferred.
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The person in this position will provide the strategic leadership for Kaiser Foundation Health Plan to compete as the quality leader in health care. On behalf of the Health Plan, the individual in this role has the overall responsibility for ensuring the quality, safety, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system. This leader partners with the market Permanente Medical Group to ensure care delivery strategies meet regulatory and accreditation compliance; aligns with national and market policies and programs related to quality and safety; and establishes/oversees quality management systems and governance. The role functions on behalf of the KFHP/H Board of Directors to provide effective quality oversight of both facility and provider credentialing. It also proactively collaborates with key Health Plan and physician leaders across the national system to support the delivery of high quality, cost-effective, integrated healthcare to members and patients. Core work includes the development and implementation of strategic quality and safety oversight objectives, quality oversight programs and corrective action plans for continuous quality improvement, and the development and monitoring of measures for safe, timely, effective, efficient, equitable, and person-centered care.
It supports compliance and the Principles of Responsibility by maintaining privacy, protecting assets, acting with ethics and integrity, reporting non-compliance, and adhering to applicable laws, regulations, accreditation and licensure requirements, and Kaiser Permanente policies and procedures. Essential Responsibilities
Directs a high functioning team of quality and safety professionals who oversee quality, safety, infection prevention, and regulatory/accreditation compliance of programs and services provided to KP members and patients in all areas of the KP market care delivery system. Partners with Permanente Quality to provide overall leadership of the KP market’s quality of care program for the delivery system including ambulatory, inpatient, dental, continuing care services as well as contracted hospitals and network providers. Partners with the Hospital Administrator(s) to provide leadership and oversight of the Hospital Quality program, ensuring activities are in alignment with, approved, and directed by the Board of Directors (QHIC). Drives, and when appropriate, partners with market PMG quality and/or operational leaders in the development of quality oversight programs and systems that position Kaiser Permanente as the quality leader in the marketplace through participation in externally benchmarked measurement programs (e.g., HEDIS, CMS 5 Star, NCQA, Patient-Centered Medical Home, Leapfrog). Identifies obstacles, barriers, and issues impacting the KP market’s ability to meet its quality, workplace safety, patient safety, clinical risk management and regulatory goals and objectives. Represents the KP market in strategic matters locally and nationally, relating to issues of clinical quality, service quality, safety, and risk (e.g., market quality oversight committees, KPNQC, SERCIT, Board of Directors). Collaborates with national functions (e.g., Care Management Institute, IRPMO) and other units to obtain ongoing data on quality outcomes and member/community health status improvements. Leads Quality Program Administration, including quality management oversight, health care delivery oversight, assessment, and intervention. Supports Population Health Community of Practice to develop strategic prevention plans, implement program guidelines, and evaluate outcomes for members’ health using HEDIS targets and outcomes. Partners with care delivery leaders by providing timely and accurate quality and regulatory advice, information, consultation and measuring satisfaction of accountable services. Collaborates with Compliance and operations to minimize clinical risk and maximize quality outcomes. Ensures Accreditation, Regulatory Compliance and Licensing as appropriate. Directs activities to ensure that the KP market obtains and maintains full NCQA accreditation and meets CMS, state, and other regulatory requirements (examples include Medicare 5-star, Joint Commission, Det Norske Veritas, American Heart Association). Ensures effective execution of business strategies by aligning human resource strategies with business needs, recruiting and developing a high-performance team, and creating a climate that builds employee commitment and reinforces performance, customer service and quality outcomes. Contributes to and utilizes national strategies and capabilities; promotes sharing of new learnings and innovations. Develops and implements an approach to quality and licensing/regulatory services that integrates strategy with day-to-day operations. Provides interface between Health Plan and the market Permanente Medical Group for a variety of initiatives including quality and safety oversight. Drives internal initiatives to improve overall performance by addressing unreliable, poorly controlled, ineffective, inconsistent, and duplicative processes. Builds and maintains responsive, motivated, and efficient departments that ensure results orientation. Qualifications
Experience
Minimum eight (8) years management experience, with a minimum of five years in healthcare operations. Education
Master’s degree required. License, Certification, Registration
Registered Nurse License (from any state) required at hire OR Pharmacist License (from any state) required at hire Pharmacist License (Oregon) within 3 months of hire OR Registered Nurse License (Oregon) within 3 months of hire Additional Requirements
Service Orientation: Develops long-term strategies to enhance member/customer satisfaction. Listening: Understands stakeholder needs and concerns into effective programs. Integrated Thinking: Synthesizes varied viewpoints and priorities. Communication: Tailors communication to engage audiences and translate strategy into action. Influence: Builds program-wide relationships to move initiatives forward. Team Focus: Fosters collaboration and adapts management style for team performance. Change Leadership: Manages long-term change with a clear roadmap. Decisiveness: Makes informed decisions addressing key threats and opportunities. Results Orientation: Tracks results against external benchmarks. Cultural Competence: Serves diverse local populations. Develops Others: Coaches and mentors future leaders. Personal Development: Seeks challenging opportunities to meet development needs. Knowledge of quality oversight, accreditation, and regulatory compliance for Health Plan hospital and medical group. Leadership experience with regulatory agencies and integrated care delivery systems. Analytical and problem-solving skills; ability to motivate change through data interpretation. Ability to balance strategic vision with day-to-day operations; build partnerships with physician and labor groups. Willingness to challenge the status quo and act as a risk taker. Excellent interpersonal, negotiation, listening, and communication skills with diverse stakeholders. Strategic/Systems Thinking (3+ years): ability to formulate unit strategy. Preferred Qualifications
Graduate degree in business administration, nursing, or health care administration is preferred. Current RN license preferred.
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