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Kaiser Permanente

Integrated healthcare provider and payer platform

Managerial Consultant V - Prospective Medicare Risk Adjustment

Business OperationsConfirmed live in the last 24 hours
Full-timeOakland, CA, USANo salary listedIn-person

About the Job

Requirements

  • A minimum of two years of experience in a leadership role, with or without direct reports.
  • A bachelor's degree from an accredited college or university and a minimum of eight years of experience in consulting, project management, data analytics, operations, or a directly related field; or a master's degree in Business Administration, Public Health, Health Services Administration, or a related field and a minimum of six years of experience in consulting, project management, data analytics, operations, or a directly related field; or a minimum of eleven years of experience in consulting, project management, data analytics, operations, or a directly related field.

Responsibilities

  • Support prospective Medicare risk adjustment initiatives across Kaiser Permanente markets.
  • Partner with physician groups, market leadership, and cross-functional teams to analyze performance, identify opportunities, and implement operational improvements.
  • Support Medicare Market Executives in advancing market priorities and contribute to strategic projects.
  • Serve as a lead consultant coordinating diverse stakeholders to implement strategic business initiatives and projects or programs across multiple functional tracks or workstreams.
  • Drive business strategy, organizational alignment, and prioritization of business initiatives.
  • Lead the work of project and program team members by coordinating resources, communicating strategic objectives, and delivering performance feedback to team members' supervisors and leadership.
  • Develop and implement business initiatives, systems, and processes to achieve a desired future state.
  • Manage complex, cross-functional projects and programs, including scope, schedules, resource forecasts, risks, issues, and mitigation strategies.
  • Design and lead change-management plans associated with business initiatives.
  • Lead assessments of strategic performance metrics and use data-driven analysis to evaluate business solutions.
  • Participate in vendor management by reviewing vendor performance, ensuring service-level agreements are met, managing vendor invoices, and partnering with Procurement or Legal on service-level or scope-of-work agreements.
  • Monitor compliance of work activities with Kaiser Permanente, departmental, and business-line policies and procedures.
  • Conduct or oversee business-specific projects, develop work plans, coordinate and delegate resources, solve complex problems, monitor results, and escalate high-priority risks or issues.
  • Build stakeholder partnerships, develop goals and deliverable priorities, facilitate decisions, resolve complex stakeholder issues, and present reports to executive audiences.
  • Define and evaluate performance metrics, lead strategic roadmaps, manage complex initiatives or portfolios, and ensure measurable results align with strategic objectives.
  • Develop business, functional, and non-functional requirements and oversee comprehensive business cases assessing costs, benefits, and return on investment.
  • Map current-state and future-state processes, identify operational impacts and value gaps, recommend process enhancements, and establish governance and workgroup infrastructures.
  • Develop risk mitigation plans and resolve or escalate client, project, program, and business risks, issues, and trigger events.
  • Provide training, guidance, coaching, and continuous-improvement leadership to stakeholders and consulting teams.
  • Ensure business plans and team members adhere to relevant policies and procedures.

Desired Qualifications

  • Four years of experience working in physician strategic consulting.
  • Four years of experience working with policy, regulatory, licensure, and compliance operations.

About the Company

Kaiser Permanente

Integrated healthcare provider and payer platform

Kaiser Permanente runs an integrated healthcare platform that lets members manage and pay medical, premium, and pharmacy bills online. It serves Medicare Advantage, Individual and Family, and non-employer plans, offering options to pay as a guest or set up payment plans. The platform works by presenting a centralized online portal where users can view bills, choose how to pay, and handle multiple types of charges in one place. Revenue comes from premiums and medical services fees, while the service aims to reduce administrative work for both providers and patients and encourage on-time payments. What sets Kaiser Permanente apart is its combination of healthcare services with a single billing experience across multiple plan types, focusing on a user-friendly, centralized payment process rather than handling billing through separate systems. Its goal is to provide a straightforward, reliable way for members to manage and pay their bills, improving convenience and payment timeliness.

Company size
10,001+
Company stage
Grant
Total funding
$7.5M
Headquarters
Oakland, CA
Founded
1945

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