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Posted: Monday, January 8, 2018 2:28 AM

Description: Description

The manager of the Health Plan Performance Consultants provides leadership for Performance Consultants embedded within the health plan. Assures achievement of regulatory and contractual compliance for all lines of business.

Responsibilities include consultation and guidance on the development and monitoring of regulatory and performance goals, targets and action plans in all health plan departments. Manages the coordination of federal and state regulatory and CMS MA policy changes to all affected areas. Participates in multi-disciplinary teams to identify and resolve complex compliance issues and required systems changes. Responsible for understanding current and new regulatory requirements; coordinating the implementation of new regulatory requirements; overseeing departmental policies & procedure annual updates; overseeing First Tier, Downstream and Related Entity (FDR) and external vendor monitoring of the operational areas; overseeing the corrective action plan process (CAPs); and performing departmental risk assessments.

Qualifications

Education

Minimum Education Requirements

Bachelors degree or equivalent combination of education and experience in lieu of educational requirements.

Preferred Education

Masters Degree Health administration, health services planning, business administration or related field

Knowledge/Skills

Minimum Knowledge/Skills Requirements

Direct working knowledge of health plan laws or regulations, regulatory guidance and compliance. Demonstrated leadership in complex thinking and problem solving, root cause analysis and systems thinking. Proven ability to lead and manage teams and engage staff. Knowledge of state and federal health program requirements. Proven ability to balance competing Kaiser interests in health plan operations and systems, with customer and purchaser requirements. Strong interpersonal, influence, negotiation and communications skills; ability to establish trust.

Preferred Knowledge/Skills

Ability to synthesize and communicate complex governmental requirements to operations managers and staff. Existing relationships with regional and national regulatory staff. Strong knowledge of Kaiser Permanente operations and business objectives. Proven ability to lead and manage cross-functional teams and engage staff.

Experience

Minimum Experience Requirements

3 years compliance program management experience

Preferred Experience

4 years leadership and administration of health plan regulatory requirements, with emphasis on overall operational compliance for all lines of business. Demonstrated experience with complex problem-solving for compliance outcomes. Operational experience with multiple lines of business within health plan operations including state, federal and commercial regulatory requirements.

License/Certifications

Minimum License/Certifications Requirements

None Required

Preferred License/Certifications

Able to obtain shortly after hire Certification in health care compliance or equivalent.

Kaiser Permanente is an Equal Opportunity Employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, marital status, age, sexual orientation, gender identity or expression, or any other legally protected status.

Job Type: Standard Employee Status: Regular Job Level: Manager Job Category: Legal and Compliance Travel: No

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SDL2017


Associated topics: assistant general manager, captain, lieutenant, manager in training, petty officer, planning operations, police commander, project manager, sergeant, shift supervisor

Source: http://www.jobs2careers.com/click.php?id=4709556599.96


• Location: Seattle

• Post ID: 60907932 seattle
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