Program Manager V, Strategy Execution - National Medicaid Quality

Kaiser Permanente; Oakland (CA); On-site; USD 170,000 - 220,000; Full time

Job summary

Kaiser Permanente is seeking a technical functional leader to oversee enterprise-wide Medicaid Quality programs across regions, coordinating governance, data analysis, and cross-functional collaboration. This role reports to the VP and partners with California teams to advance quality initiatives and regulatory compliance.

The position emphasizes strategic planning, risk management, and leadership in a fast-paced health system, with a focus on improving outcomes and health equity through

Qualifications

• Minimum three (3) years experience working with senior leadership to deliver cross-regional or multi-disciplinary strategic program management.
• Minimum three (3) years experience in a leadership role with or without direct reports.
• Bachelor's degree and minimum eight (8) years experience in project management or a directly related field, including minimum four (4) years program management experience OR eleven (11) years experience in project management or a directly related field including minimum four (4) years program management experience.

Responsibilities

• Coordinates cross-regional Medicaid Quality initiatives and governance structures.
• Leads and organizes forums for cross-regional collaboration among Medicaid leaders.
• Develops and maintains program plans, risk registers, and change-management activities across regions.
• Monitors program performance and escalates risks or issues to senior leadership.
• Partners with California-based teams to align national Medicaid Quality efforts.
• Supports data sharing and reporting for quarterly business reviews and governance forums.

Skills

Project management

Data analysis

Cross-functional collaboration

Stakeholder management

Education

Bachelor's degree

Job description

Overview

This core position works directly with the Vice President, Associate CMO for Medicaid and State Programs to integrate and facilitate coordination of Medicaid Quality initiatives across all regions. Strong project management skills, ability to work closely with data to inform decision making, and strong collaboration with multiple partners in a highly matrixed role will be critical to the success of this position.

Essential Responsibilities

• National Medicaid Model of Care
• Coordinates project team to develop approach for Government Programs risk stratification
• Prepares regular project status updates (ie. Medicaid Goals Update)
• National Medicaid Quality Governance
• Organizes forums for cross-regional Medicaid Quality collaboration (ie Regional Quality Medicaid leads, Regional Medicaid Medical Directors.)
• Supports regional launch of Medicaid Quality governance structure (ie Government Programs Oversight Committee)
• Collaborates closely with California-based team for National Medicaid Quality and Health Equity
• Builds and maintains strong relationships with Medicaid quality leadership of all regions
• Helps spread best practices in Medicaid quality governance and systems among regions
• Prepares regular project status updates (ie. National Quality A3)
• Data and Reporting
• Creates a repository of Medicaid quality data from all regions; analyzes and escalates trends and issues of concern; understands improvement opportunities and health disparity trends
• Collaborates with NMQHE team to analyze and prepare market level data for quarterly business report out
• Contributes to development of an enterprise-wide strategy to optimize NCQA Medicaid ratings
• Medicaid Behavioral Health Quality
• In partnership with the Population Health Management Quality Strategy Lead, Care Delivery Operations, PMG and other relevant stakeholders, shape Kaiser Permanente's California Medi-Cal behavioral health quality strategy by establishing governance, reporting, measurement, and oversight frameworks that advance behavioral health outcomes and regulatory compliance
• Provide Medicaid-specific leadership for behavioral health data-sharing initiatives, translating regulatory requirements into cross-functional implementation strategies, quality reporting capabilities, data governance processes, and operational execution plans.
• Leadership Communications and Support
• Builds repository of projects and presentations for NMQHE team
• Helps organize presentations and dissemination activities for VP, Associate CMO Medicaid Quality and ED, Chief Health Equity Officer, National Medicaid
• Supports NMQHE communication through dissemination with high level of skill and professionalism (powerpoint, written briefs and articles, etc)
• Communicates NMQHE goals and strategies in a variety of forums (internal and external meetings, to partner teams in the organization)
• Co-facilitates bi-monthly and bi-weekly internal team meetings; supports on-site agenda design

Job Summary

In addition to the responsibilities listed below, this technical functional leader is also responsible for managing strategic, enterprise-wide, cross-regional, and/or multi-disciplinary programs to drive exceptional business value for KP; managing evolving strategic priorities and providing strategic planning within and across programs to drive and ensure alignment and performance across the organization. This includes regularly monitoring the progress of initiatives across the program and proactively identifying risks and opportunities of strategic business value; raising visibility on critical issues to ensure effective resolution; and identifying, gathering and evaluating data and key performance drivers to understand strategy performance and any gaps. This position is also responsible for providing design plans and supporting the development and execution of change management strategies during key program or organizational changes and transitions; working in a variety of dynamic situations requiring exceptional consulting, internal influence, conflict management, and resource/team management; proactively conducting external research to identify and implement market leading practices; embracing a can-do strategic approach with sound business acumen; and advising and partnering with senior leaders while operating within a fast-paced environment.

Essential Responsibilities

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Manages large-scale programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability for achieving program outcomes from initiation to close-out in an extended or open ended time frame. Develops, analyzes, and manages highly complex program plans which include scope identification and management, schedule, inter-dependencies, and resource forecast. Manages and monitors the program financials of large-scale programs. Monitors program performance to ensure programs effectively deliver maximum long term value or benefit to the organization, and makes adjustments as needed in an uncertain environment where scope may be fluid. Leads program activities related to organizational change management (e.g., development and execution of user adoption, implementation, and training plans) as defined by the program. Drives allocation of resources, establishes schedules, and task assignments to ensure established program management practices are in place. This role may perform project management duties in addition to program management responsibilities.
• Leads the work of large program teams by monitoring internal and external resources. Leads others in requesting and coordinating internal and/ or external resources based on the alignment of team member skills and program demands. Communicates a clear vision of program goals and objectives to the team. Delivers performance feedback to team members supervisors.
• Proactively monitors, identifies, and mitigates program risks, issues, and trigger events by developing mitigation plans and strategies; and resolving or escalating risks or issues as appropriate.
• Monitors adherence of program activities to policies and procedures by ensuring program plans and team members follow KP, departmental, and/or business line policies and procedures.
• Ensures the alignment, buy-in, engagement and support of diverse program stakeholders by building and maintaining relationships as well as communicating appropriately with internal customers, third party vendors, senior management, and business leaders; and clarifying accountability and authority across stakeholders. Identifies and works closely with key stakeholders based on their level of influence and decision making and ensures all appropriate stakeholders are represented and included. Provides insight to key stakeholders and program sponsors by developing program goals, setting the prioritization of deliverables, discussing involvement of business processes (e.g. program change management, communication) and facilitating decisions necessary for program delivery. Communicates tough issues to stakeholders while maintaining an independent opinion, providing recommendations, delivering formal presentations, and providing reports to various senior audiences. Engages with senior stakeholders to identify long term value to the organization and define success.
• Reviews vendor performance levels and ensures service level agreements are met. Partners with Procurement and/or Legal to develop service level and/or scope of work agreements as appropriate. Participates in contract negotiations with vendors and reviews program invoices submitted by vendors for accuracy.

Minimum Qualifications

• Minimum three (3) years experience working with senior leadership to deliver cross-regional or multi-disciplinary strategic program management.
• Minimum three (3) years experience in a leadership role with or without direct reports.
• Bachelors degree from an accredited college or university and minimum eight (8) years experience in project management or a directly related field, including minimum four (4) years program management experience OR Minimum eleven (11) years experience in project management or a directly related field including minimum four (4) years program management experience.

Primary Location: California,Oakland,Ordway

Scheduled Weekly Hours: 40

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri

Working Hours Start: 08:00 AM

Working Hours End: 05:00 PM

Job Schedule: Full-time

Job Type: Standard

Worker Location: Flexible

Employee Status: Regular

Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee

Job Level: Individual Contributor

Department: Po/Ho Corp - Medicaid Quality - 0308

Pay Range: $169800 - $219670 / year

Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. 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.

Travel: Yes, 10 % of the Time

Work Setting: Flexible

Worker location must align with Kaiser Permanente's Authorized States policy.

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.