|Date Posted||November 12, 2020|
This position reports to both the Regional President and the VP, Group Operations, Markets Outside California. This position serves as a member of the market-s health plan leadership team and is the senior market executive accountable for the development and execution of experience strategies within the market and across the Company enterprise that make it easy and intuitive for consumers to get the care and service they need every time. Informed by voice of the member analytics, this leader partners with Permanente Medical Group and Health Plan regional and national leaders on strategic planning, direction, and management of workflows, systems and organizational improvements of overall satisfaction across health plan and delivery system experiences. Accountable for overseeing several Consumer Experiences including -Welcomed as a New Member-, -Connecting to Care-, and -Telehealth- as well as line of business targeted strategic improvements (e.g. Medicare Satisfaction), this leader oversees execution of an integrated set of dependent functional operations and enterprise strategies that improve engagement and satisfaction with Company. This role provides the leadership, vision, and strategic and operational direction for engaging consumers with care delivery operations. As the market health plan accountable executive for access and clinical contact center operations (appointing and advice), this position will partner with care delivery leaders on continued improvement of high-quality, easy to get accessible care for our members and patients. Accountable for leading initiatives which improve the overall satisfaction across health plan and delivery system member experiences, this position oversees market-based Health Plan Service Administration operations (variable by market) as well as integration of market improvement initiatives with shared services functions. Market leaders accountable for HPSA operations have accountability to the National leader of Health Plan Product, Service and Administration (HPPSA) for end to end HPSA operational performance of shared services, the successful execution of strategic system and product deployments, the annual open enrolment cycle and the advancement of the -Effortless Health Plan Experience- agenda. This position requires high-level collaboration and influencing skills to deliver customer and member services from a mix of shared services operations and region operations and actively partnering and influencing delivery system and medical group leadership to ensure a seamless member experience between health plan and delivery functions, supports efficient and effective medical office (ambulatory) operations as well as outside medical cost management, and regulatory compliance. This position consistently supports compliance and the Principles of Responsibility (Company-s Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licensing requirements (if applicable), and Company-s policies and procedures.
- Strategic Leadership: Accountable for designing and overseeing the execution of vision and strategies to streamline and optimize member experience in accordance with the Company Experience Strategy.
- Improves member satisfaction through in-depth collection of data and comprehensive analytics. Uses market analysis to actively develop new customer service (and self-service) ideas and enhancements. Identifies line of business specific needs and requirements.
- Identifies and advances opportunities across markets to leverage market resources in design and development of experience strategies
- Prioritize opportunities to reduce complaints and grievances, social media, real time patient feedback and care experience patient satisfaction surveys; solve service gaps and improve services across Medical Centers and Health Plan Operations.
- Establishes regional processes and structures for Access Management in accordance with national standards and processes. Works in collaboration with Care Delivery leadership to provide analysis and strategic planning to drive access through all care channels, including virtual care.
- Identifies improvement opportunities to leverage systems, processes, standardization, technology, or other vehicles to improve overall performance and lower cost while maintaining or improving customer service.
- Provides strategic leadership for market-based appointing and nurse advice experiences and related operations. Works in collaboration with Delivery System Vice Presidents to provide analysis and strategic planning to drive access as well as the appropriate distribution/consolidation of various free-standing call center operations (e.g. Radiology and Specialty Appointing)
- In collaboration with Permanente Medical Group, defines and executes regional Telehealth operating plan in accordance with enterprise strategy.
- Partner with HP and PMG Care Delivery leadership to define and execute strategies that optimize the organization-s 24-hour Clinical Contact Center asset to improve the member experience, efficiency of delivery system operations and the quality of patient care.
- Manages and maintains priority issues for escalation to the regional Health Plan leaders, Permanente Medical Group, labor partners, National Health Plan Administration Leaders and the appropriate governance structures.
- Operations Leadership: Acts as the voice of the customer and member in the establishment, monitoring and improvement of performance measures, metrics and service level agreements across health plan administrative and care delivery functions.
- Defines and oversees operation workflows for operational service recovery (social media, real time feedback surveys, complaints resolution) across health plan and delivery system functions.
- Provides operational leadership for Appointment and Advice in the region, including but not limited to Primary, Specialty, and Radiology Appointment scheduling, Nurse Advice, Chat and New Member Onboarding.
- Works with Permanente Medical Groups to ensure efficient and streamlined access and service workflow and processes (e.g. appointment templates, scheduling processes and booking guidelines). Monitors and escalates emerging access gaps as demand is presented with insufficient supply to meet expectations.
- Fosters continuous quality and service improvement based upon regular problem identification. Regional and National Service Quality reports will be used to assist with identifying opportunities.
- Influences customer adoption of innovative technologies.
- Accountable for benefits realization ensuring all processes for contact services are standardized, following best practice procedures and complete. Responsible for all appropriate data/metric/report information is collected, analyzed, summarized, distributed and improved upon.
- Manages multiple departments and works with cross-functional and cross-departmental teams on prioritization. Manages additional external resources and cross market work teams which may be needed to advance cross market work, subject matter expertise or staff augmentation.
- Tracks record of maintaining high-quality standards for the organization. Understands key process issues and makes sure process improvements happen. Tracks issues and facilitates timely resolution of obstacles/issues
- Develops and achieves budget and fiscal targets as well as provide direct contribution to cost reduction through the design of efficient work-flow process, staffing systems and application of appropriate technology.
- People Leadership: Ensures efficient, ongoing operations of direct responsibilities through an effective organizational structure, and the selection, development, appraisal, motivation and retention of competent personnel.
- Fosters and maintains a culture of empowerment, engagement, trust, and accountability
- Establishes vision and strategies aimed towards a high performing and best place to work environment across the Operation.
- Designs and executes leadership development strategies in conjunction with Organizational Effectiveness that enables a high performing management culture
- Exemplifies, promotes and supports development of work group empowerment, improved communications, individual initiative, creativity, and environment characterized by a strong ethic of trust, cooperation and personal commitment and respect of the individual.
- Minimum ten (10) years in operations in a large-scale health plan and /or care delivery system; preferably in an integrated system.
- Bachelor-s degree required in health administration, business, or a related field.
License, Certification, Registration
- Experience in customer, member and or patient care satisfaction continuous performance improvement.
- Demonstrated success in leading significant organizational change and exercising senior leadership decision-making
- Experience in successfully managing large scale systems and workflow integration projects
- Experience in preparing budgets and successfully managing expenses within budget
- Demonstrated success in delivering results within available resources.