Job Summary: Kaiser Permanente is seeking a transformational and enterprise-minded leader to serve as the Executive Director, Risk Adjustment Strategy & Transformation. Reporting to senior leadership within National Health Plan Risk Adjustment, this executive will serve as a key enterprise stakeholder and strategic partner in the development, governance, and evolution of cross-functional initiatives that support clinical documentation excellence, coding accuracy, encounter data integrity, and value realization across the organization. The Executive Director will be responsible for partnering with leaders across the Permanente Medical Groups, ICC, Health Plan, Revenue Cycle, Technology, Finance, and regional operations to translate enterprise objectives into measurable clinical, operational, and financial outcomes. Through a highly collaborative and co-design-oriented approach, this leader will help identify opportunities, align priorities, facilitate decision-making, and support the development and implementation of technology-enabled and AI-enabled solutions across the member care journey. A key responsibility of this role is fostering effective enterprise governance and stakeholder engagement to advance shared objectives. Working through established governance structures, including the Care Delivered, Value Captured, Unrivaled Experience (CDVCUE) Board and its cross-functional stakeholders, the Executive Director will facilitate collaboration, support strategic alignment, promote transparency, and help ensure coordinated execution across interconnected initiatives. Success will depend on the ability to bring together diverse perspectives, build consensus, and create alignment around enterprise priorities while respecting the distinct roles, responsibilities, and expertise of participating organizations. Leading a small team of strategy and transformation professionals, the Executive Director will serve as a trusted advisor, connector, and catalyst across the enterprise. This leader will influence without direct authority, support stakeholder-driven solution design, and help create the conditions necessary for successful implementation and sustainable adoption of strategic initiatives. Beyond implementation, the Executive Director will help establish and sustain an enduring enterprise capability by partnering with stakeholders to define success measures, monitor performance, identify emerging opportunities and risks, and drive continuous improvement. This role will also support National Health Plan growth and expansion efforts through enterprise capability assessment, capability development, and integration activities, including support for initiatives such as Kaiser Permanente Nevada (KPNV) and future growth opportunities. Through collaborative leadership, shared accountability, and enterprise-wide partnership, the Executive Director will help strengthen member outcomes, enhance provider and patient experiences, improve operational effectiveness, support reimbursement integrity, and advance Kaiser Permanentes long-term clinical and financial performance.
Essential Responsibilities:- Strategy and Transformation Leadership: Lead the overall strategy, governance, operating model, implementation roadmap, and execution of the CDVCUE initiative. Establish enterprise objectives, key milestones, success metrics, accountability frameworks, and organizational priorities. Ensure initiative activities remain aligned with enterprise strategy, value-based care objectives, regulatory requirements, and financial performance goals.
- Cross-Functional Leadership and Organizational Alignment: Develop strong working relationships with executive leaders across National Health Plan, Permanente Medical Groups, Care Delivery, Technology, Revenue Cycle, Claims, Finance, Compliance, Legal, Consumer Experience, Scheduling, and Benefits Administration. Create alignment on priorities, establish shared ownership of outcomes, and facilitate resolution of cross-functional issues and competing priorities.
- Implementation and Program Execution: Translate strategic objectives into executable implementation plans with defined workstreams, deliverables, dependencies, timelines, and resource requirements. Monitor progress, manage risks, escalate barriers, and ensure timely achievement of critical milestones. Drive accountability for execution across matrixed teams and stakeholders.
- Full Kit Solution Development and Operational Integration: Oversee the design, development, testing, implementation, and operational integration of Clinical Full Kit, Scheduling Full Kit, Patient Encounter, and Submission Full Kit capabilities. Ensure solutions are scalable, sustainable, standardized where appropriate, and integrated across workflows, technologies, and organizational boundaries.
- Financial and Business Value Realization: Work closely with Finance, Risk Adjustment, Revenue Cycle, and business leaders to establish value realization targets and benefit tracking methodologies. Monitor achievement of operational, clinical, and financial outcomes and ensure initiatives support reimbursement integrity, margin improvement, affordability goals, and responsible stewardship of resources.
- Technology Enablement and Process Transformation: Partner with technology and operational leaders to identify opportunities for automation, workflow optimization, analytics, decision support tools, artificial intelligence capabilities, data quality improvements, and process redesign. Ensure technology investments enable sustainable improvements in care delivery, documentation, coding, encounter management, and data submission processes.
- Compliance, Risk Management, and Governance: Partner with Legal, Compliance, Privacy, Internal Audit, and operational leaders to identify risks, implement controls, maintain regulatory compliance, and ensure initiative activities align with Kaiser Permanente policies, standards, and ethical expectations.
Basic Qualifications: Experience
- Minimum eight (8) years of progressive leadership experience within healthcare, including health plans, integrated delivery systems, healthcare operations, population health, revenue cycle, risk adjustment, care delivery transformation, healthcare technology, consulting, or related disciplines.
Education
- Bachelors degree in healthcare administration, Health Policy, Business Administration, or a related field is required.
License, Certification, Registration
Additional Requirements:- Requires significant direct risk adjustment experience with demonstrated understanding of prospective and retrospective risk adjustment programs, documentation and coding operations, encounter data, value-based reimbursement methodologies, revenue capture processes, and regulatory requirements.
- Experience may be obtained through a nationally recognized consulting firm or internal consulting/transformation organization.
- Demonstrated success leading enterprise-wide transformation initiatives requiring coordination across multiple business units, markets, regions, executive stakeholders, and operational teams.
- Experience creating and executing enterprise implementation roadmaps, governance structures, accountability frameworks, operating models, and organizational change strategies.
- Experience partnering with physician leaders, operational leaders, finance organizations, technology organizations, and executive leadership teams to drive business outcomes and large-scale adoption of new capabilities.
- Experience developing executive-level presentations, business cases, strategic recommendations, implementation plans, and performance reporting for senior leaders and governing bodies.
- Experience leading highly matrixed organizations and driving results through influence rather than direct authority.
Preferred Qualifications: - Advanced degree preferred (MBA, MHA, MPH, MS, or equivalent graduate degree) preferred
- Preferred RN or another clinical certification
- Preferred Certified risk adjustment coder certification.
- Professional certifications in Program Management, Change Management, Lean, Six Sigma, Agile, Healthcare Operations, Healthcare Technology, or related disciplines are preferred.
- Preferred three (3) years of healthcare consulting experience supporting large-scale strategic, operational, technology, or organizational transformation initiatives.
- Knowledge of integrated healthcare delivery systems, payer-provider models, and value-based care arrangements strongly preferred.
Primary Location: California,Oakland,Ordway
Additional Locations: - Atlanta, GA
- Denver, CO
- Pasadena, CA
- Portland, OR
- Seattle, WA
- Washington D.C., DC
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon-Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE Executives|NUE|Non Union Employee
Job Level: Director/Senior Director
Department: Po/Ho Corp - 3YP Core - 0308
Pay Range: $256500 - $320625 / year Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: Yes, 15 % of the Time
Flexible: Work location is on-site at a KP location, with the flexibility to work from home. Worker location must align with Kaiser Permanente's Authorized States policy.
