SVP, Health Plan - East Market

Overview

The Senior Vice President, Kaiser Permanente Health Plan (SVP, KPHP) is a collaborative, strategic leader responsible for the overall health plan performance, growth, and profitability across all product lines within their market(s). This role requires strong communication, adaptability, and the ability to build consensus in a complex, matrixed environment. The SVP partners closely with Regional Presidents (RP), Executive Medical Directors (EMDs), and national function leaders to drive membership growth, revenue, and margin sustainability.

Key responsibilities encompass overseeing line of business performance specifically for membership growth, mix, and rate setting, underwriting, health plan operations, and customer and broker relationships. The leader is also responsible for the evaluation of trend and trend drivers for both customer rate rationalization and affordability management. The role works directly with various teams to provide and support network management, contracting, operational setup, billing, and payment integrity, as well as other essential health plan services.

This involves collaborating with leaders at national, regional, and care delivery levels to ensure outstanding value and quality for both members and customers.

The SVP of KPHP will collaborate with the Regional President and EMDs to evaluate strategic health plan line of business membership opportunities and challenges, and to create and implement subsequent business plans. Further, the position is responsible for the development and execution of health plan strategies to ensure they are coordinated across different regions, business areas, and products, supporting key performance goals.

Duties include anticipating changes in policy, using market insights and data, and assessing membership trends to spot and pursue growth prospects. The SVP will turn these findings into practical strategies that drive improvement in health plan performance.

The SVP, KPHP, Regional Presidents, and EMDs for each market operate together as a unified team. The organization’s success depends on cross-functional collaboration and shared accountability. Integrated leadership is the strength of Kaiser Permanente’s model that drives distinctive quality and affordability. The SVP aligns efforts through regular, structured collaboration to ensure clarity, consistency, and progress toward shared goals. Each leader is responsible for driving performance in their respective domain, delivering key metrics, actions, and updates, while working together on the collective vision for the market.

The SVP is responsible for the market’s health plan success, contributing to profit and loss results and ensuring financial performance aligns with budget and long-term plans. This leader anticipates market changes, leverages data and insights, works with key leaders across the organization to ensure regulatory compliance and to enhance the member experience. Success in this role depends on effective collaboration, shared accountability, and commitment to Kaiser Permanente’s mission of integrated, value-based care.

• Partnership with Regional President(s) and Executive Medical Director(s):
  Collaborate with regional president(s) and Executive Medical Director(s) to align and lead operations and initiatives to achieve market leading growth and total margin.
• Strategic Planning & Alignment:
  Partner with Regional Presidents (RP) and Executive Medical Directors (EMDs) to define health plan strategic priorities by defining revenue sufficiency, target markets, products, and capital needs. Completes competitive intelligence and market SWOT development and product market fit to ensure strategies are aligned across geographies, business lines, and products.
• Performance & Growth Management:
  Drive financial and health plan operational success by partnering with regional leaders, supporting sustainable health plan revenue growth, profitability, and market competitiveness across all product lines.
• Rate Setting & Underwriting:
  Partners with RP to lead rate setting and partners with underwriting and actuarial teams to ensure competitive pricing,…