Vice President, Quality & Safety - Northwest Market

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.

The leader 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, the development and implementation of quality oversight programs and corrective action plans to ensure continuous quality improvement, and the development and monitoring of measures for safe, timely, effective, efficient, equitable, and person-centered care that assess impact on health of members and communities.

This position supports compliance and the Principles of Responsibility (Kaiser Permanente’s Code of Conduct), including privacy and confidentiality, asset protection, ethics and integrity, reporting non-compliance, and adherence to applicable laws, regulations, accreditation and licensure requirements, and Kaiser Permanente policies and procedures.

• 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, contracted hospitals and network providers.
• Partners with 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 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 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 within the KP enterprise to obtain appropriate, ongoing data on quality outcomes and member/community health status improvements.
• Leads Quality Program Administration (QHIC processes) 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 programs to monitor 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 measures 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 the KP market obtains and maintains full NCQA accreditation, meets CMS, state and other regulatory requirements, achieving high award recognition (e.g., Medicare 5-star, Joint Commission, Det Norske Veritas, American Heart Association).
• Ensures effective execution of business strategies by aligning HR strategies with business needs, recruiting and developing a high-performance team, and creating a climate that builds employee commitment, 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…