Vice President and General Manager
About the job
- A minimum of ten years of experience in healthcare management, including at least five years in leadership roles overseeing Medicare Advantage operations and network development.
- A bachelor's degree in Business Administration, Healthcare Management, or a related field, or equivalent experience, or four years of experience in a directly related field.
- A High School Diploma or General Education Development (GED) is required.
- Deep understanding of the health care industry and its dynamics.
- Demonstrated expertise in Medicare Advantage health plans, integrated delivery systems, value-based care models, and provider engagement.
- Strong knowledge of CMS regulations, Medicare Advantage operations, health plan financial management, and clinical operations.
- A proven track record of driving growth, improving network performance, and achieving financial and clinical quality excellence.
- Proven success analyzing complex data to drive informed strategic decisions in a matrixed environment.
- Proven ability to influence a complex organization to ensure that performance standards are customer driven.
- Exceptional leadership, interpersonal, communication, and collaboration skills, along with creative and analytical problem-solving skills.
- Ability to credibly influence decision makers to take action on fact-based recommendations.
- Develop and implement competitive, market-specific strategies to achieve sustainable Medicare Advantage growth, market share, target economics, and alignment with the integrated care and coverage model.
- Lead the positioning of the organization through collaboration and influence across a large, complex, multi-regional enterprise.
- Collaborate with regional market leadership, care delivery, National Health Plan functional leaders, and other system stakeholders to align market operations and performance with organizational objectives.
- Ensure market-specific strategies align with regional economic targets and strategic growth objectives.
- Manage the regional market profit and loss for the Medicare Advantage line of business through revenue optimization and cost management.
- Develop and monitor budgets, forecasts, and financial plans, and lead regional Medicare Advantage performance management through a defined operating model.
- Align membership forecasting with strategic market objectives, ensure accurate risk-adjusted revenue, monitor medical cost initiatives, recommend network strategies, and ensure administrative efficiency.
- Identify and pursue sustainable membership growth through product development, distribution channel management, and strategic partnerships.
- Develop and execute market strategies for sustainable Medicare Advantage growth in partnership with National Medicare Sales leaders.
- Strengthen brand identity and member preference to maximize marketplace value and long-term member tenure.
- Develop and execute marketing strategies, campaigns, advertising, marketing communications, brand, and public relations strategies supporting Medicare Advantage sales, membership, revenue, and margin goals.
- Lead initiatives to improve member retention, member experience, and competitive positioning through differentiated senior care models.
- Provide strategic guidance on product development, benefit design, and core competencies to ensure market competitiveness and alignment with customer needs.
- Recommend member experience improvements and drive initiatives across the organization.
- Implement programs to improve clinical quality metrics, including Star ratings, HEDIS, CAHPS, and HOS.
- Align market-specific prevalence and acuity data with clinical program development and network strategies.
- Develop and execute care management, disease management, and population health programs for Medicare Advantage members, including Dual Eligibles.
- Drive Medicare Advantage and Duals-specific care-model innovation through partnerships with providers and value-based vendors.
- Recommend and execute network strategies addressing Medicare Advantage member needs, including senior-care, community-aligned, value-based, and potentially risk-bearing providers.
- Monitor internal and external network performance metrics, including access, utilization, cost of care, and member outcomes.
- Address network gaps related to CMS regulatory compliance, access, availability standards, member experience, and outcomes.
- Foster collaborative relationships with medical groups and external providers through transparent reporting and joint continuous-quality-improvement initiatives.
- Monitor Medicare Advantage operations to ensure member experience expectations and compliance with federal and state regulations.
- Surface potential risks through proactive management of leading indicators in partnership with compliance and operations.
- Recommend and track efficiency opportunities across government-program processes and systems.
- Ensure regional operations comply with CMS guidelines, state regulations, and internal policies.
- Monitor changes in Medicare, Dual, and Medicaid regulations and adjust strategies accordingly.
About the company
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, California
Founded
1945
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Simplify's Take
What believers are saying
- Kaiser opens Everett urgent care in 2027, extending access after its 2025 expansion.
- West Los Angeles College launched an LVN program backed by Kaiser grants in 2023 and 2025.
- Kaiser added five Everett primary care doctors in 2026, strengthening local member retention.
What critics are saying
- On September 21, 2026, Kaiser filed 147 California layoffs, effective November 20.
- Colorado union local sued on September 30, 2026 over admissions jobs moving to Georgia.
- Northern California mental health clinicians still lack a new contract after 34 bargaining sessions.
What makes Kaiser Permanente unique
- Kaiser Permanente combines insurance, hospitals, and physician groups inside one delivery system.
- Its integrated model anchors billing, care coordination, and pharmacy payment across one member experience.
- Massive California footprint and 180,000 workers give Kaiser unmatched local provider density.
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Growth & Insights and Company News
6 month growth
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3%Texas launches UnitedHealth Group investigation over denials. Texas Attorney General Ken Paxton has opened a UnitedHealth Group investigation into allegations that the company used deceptive and unlawful practices that denied Texans medically necessary care, according to his office's Oct. 5 announcement. The office said it has issued Civil Investigative Demands to the company. The probe adds state-level legal exposure for the country's largest health insurer at a time when it is replacing several senior executives. For providers, the inquiry centers on issues they deal with directly: coverage decisions, authorization practices and the role of insurers in care decisions. [TABLE OF CONTENTS] What the UnitedHealth Group investigation covers. Paxton's office said the demands seek evidence of potential violations of the Texas Deceptive Trade Practices Act and other state laws. The investigation follows reports about how the company administers health benefits and makes coverage decisions, according to the announcement. Among the allegations the office cited are reports that the company gave nursing homes financial incentives to avoid or delay transferring patients to hospitals. The office is also examining whether the company's practices could amount to the unlawful corporate practice of medicine, KLBJ-AM in Austin reported. "Alarming reports keep piling up about how United treats Texas consumers," Paxton said in a statement. Paxton is also a Republican candidate for U.S. Senate. The allegations have not been proven, and the investigation does not establish that the company violated the law. UnitedHealth told Austin television station KXAN it did not have a response to share. Related Texas probe and pending litigation. The inquiry is the second Paxton has announced against a major insurer in recent weeks. His office earlier opened an investigation into Blue Cross Blue Shield of Texas and its parent, Health Care Service Corp., over procedures for denying and delaying urgent and medically necessary care and over prior authorization requirements, according to the attorney general's news releases. UnitedHealthcare also faces new private litigation. A proposed class action filed Sept. 30 in U.S. District Court for the District of Connecticut alleges the insurer's copay accumulator policy unlawfully stopped crediting drug manufacturer assistance toward a member's deductible and out-of-pocket limit, according to the complaint. Leadership changes at the insurer. The investigation arrives after a series of executive moves at the company in September, most of them announced by the executives on LinkedIn: * Bobby Hunter, previously CEO of government programs at UnitedHealthcare, became president of UnitedHealthcare, he said Sept. 28. * Dan Kueter, who led UnitedHealthcare's commercial business, became chief commercial officer of UnitedHealth Group. * Brandon Cuevas returned from Kaiser Permanente after three years to become CEO of UnitedHealthcare's commercial business, he said Sept. 22. * Jodee Kozlak was named the company's first chief administrative officer, effective Sept. 28, according to published reports. Hunter wrote that he will focus on accelerating the insurer's "modernization agenda" to make health care more connected and easier to navigate. Tim Noel remains CEO of UnitedHealthcare, the company told Reuters, according to Healthcare Brew. The appointments draw largely on company veterans. Hunter joined UnitedHealth Group in 2011 and held a series of Medicare roles before leading government programs, according to published reports. Cuevas spent 14 years at UnitedHealthcare before leaving for Kaiser Permanente, where he was executive vice president for its national health plan. Kueter wrote on LinkedIn that his new role involves working across UnitedHealthcare and Optum to coordinate product development and innovation. What comes next. Civil Investigative Demands are an evidence-gathering step, and the attorney general's office has not announced a lawsuit or a timeline. The company's response to the demands, and any findings from the parallel inquiry into Blue Cross Blue Shield of Texas, will indicate how far the state intends to take its review of insurer coverage practices. The outcome of the UnitedHealth Group investigation will fall to a leadership team that has been in place for only a few weeks.
Washington Permanente Medical Group has appointed Taejoon Ahn, MD, MPH, as its new CEO and executive medical director, effective 30 September. Dr Ahn will lead the multispeciality medical group, which comprises over 1,200 clinicians caring for more than 550,000 Kaiser Permanente members across Washington state. Dr Ahn brings over 15 years of physician executive experience. He most recently served for 12 years as president of John Muir Medical Group. He succeeds Dorian Reid, MD, who served in an interim capacity since September 2025. WPMG is the independent, physician-owned medical group that provides care exclusively for Kaiser Permanente members in Washington. Dr Ahn will partner with regional president Cynthia Dold to continue delivering integrated care across the state.
Kaiser Permanente is laying off 147 business and administrative employees across California in November. The cuts affect 16 locations in Los Angeles, Orange, San Diego, Riverside and Alameda counties, with the largest reductions being 72 positions in San Diego and 20 in Pasadena. The Oakland-based non-profit said the layoffs do not include direct patient care staff and will not affect care quality. Kaiser stated it continually evaluates how it organises work to ensure high-quality care remains affordable and accessible. Affected employees will receive support to explore other opportunities within Kaiser, and where appropriate, severance packages and outplacement services. Kaiser employs approximately 180,000 people in California.
Major players in the health, wellness and luxury spaces bring on new HR talent in September. Healthcare and related industries remain a core driver for hiring this year, and company news releases show that extends to HR as well. Kaiser Permanente. Healthcare provider Kaiser Permanente named Shaun Smith executive vice president and chief people officer on Sept. 9, according to a news release. Smith will lead the organization's HR strategy and operations as well as lead a multiyear effort to strengthen its culture. He joins Kaiser Permanente from NewYork-Presbyterian, where he was a group senior vice president and chief people and culture officer. He will begin in the role on Oct. 12. Lyra Health. Mental healthcare benefits provider Lyra Health named Leslie Riggs CPO effective Sept. 14, the company announced Sept. 2. Riggs is especially well-suited to the role due to "her experience scaling global HR operations, her deep understanding of the connection between organizational performance and workforce wellbeing, and her commitment to our mission," Jennifer Schulz, CEO of Lyra Health, said in a news release. Riggs joined the company from Sketchers, where she led global HR. Halff. Leigh Hollis has been promoted to CPO, infrastructure consulting firm Halff announced Sept. 2. She will support the HR function in her new role while leading Halff's continued focus on project delivery and quality. She joined the firm at the Fort Worth, Texas, office in 2005 and most recently served as senior VP and an operational leader for Halff's Dallas, Frisco and Richardson offices in Texas. Ascensus. Financial services company Ascensus brought Edward Greene on board as chief human resources officer effective Sept. 14, the company announced. He will serve on the executive leadership team and lead the company's human capital strategy, talent development, organizational effectiveness and culture initiatives, Ascensus said. He previously held roles as advisor to the CEO and CHRO at Iron Mountain. He has also held past roles at Surfside Capital Advisors, Voya Financial and Fidelity Investments. Pride Industries. Pride Industries - a nonprofit organization that partners with businesses to provide employment opportunities for people with disabilities - has appointed Kim Mayes senior VP and CPO, the organization announced Sept. 16. She joins from Intel Corp., where she was most recently VP of HR. Mayes brings "a deep commitment to building engaged workplaces," Craig Levra, CEO of Pride, said in a news release. She will focus on driving growth, employee engagement and organizational performance. Exemplar Luxury Group. Gretchen Koback Pursel is CPO for Exemplar Luxury Group - a luxury collective that includes the brands Neiman Marcus, Saks Fifth Avenue and Bergdorf Goodman - effective Monday, according to a news release from the group. She brings a background in the luxury retail, beauty and wellness industries, previously holding CPO roles at Tiffany & Co., The Wella Co. and, most recently, Equinox. Koback Pursel will develop and lead a people strategy that "fosters a culture of performance," according to Exemplar.
Kaiser layoffs to impact nearly 150 workers across California. Posted: Sep 28, 2026 / 02:49 PM PDT Updated: Sep 28, 2026 / 04:26 PM PDT (KRON) - Kaiser has announced plans to cut nearly 150 jobs across the state of California. The layoffs, according to a filing with the Employment Development Department, will result in 147 people losing their jobs. Among those layoffs are 34 Bay Area job cuts. The healthcare giant will be cutting 11 jobs at its headquarters in Oakland and another job at a separate facility in Oakland on Harrison Street. In Pleasanton, Kaiser plans to cut 22 jobs. The majority of the layoffs are spread across the rest of the state with employees in Pasadena, Irvine, Corona, Los Angeles, Sacramento, Folsom and San Diego all set to lose their jobs. The job cuts, which were announced late last week take effect on Nov. 20, according to state filings. All of the layoffs are described as permanent. "Kaiser Permanente continually evaluates how we organize our work and deploy resources to help ensure high-quality care remains affordable and accessible for our members and patients," a company spokesperson told KRON4. "We recently notified 147 employees in a number of business and administrative functions that their positions will be eliminated. These positions do not provide direct patient care." Kaiser said it would be supporting affected employees as they pursued other opportunities within the company and where appropriate, providing severance, career support and outplacement services.