Senior Director Regional Member Services

Kaiser Permanente

$151K — $195K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years of senior management experience in healthcare across multiple locations.
  • 5+ years in a complex healthcare (HMO) environment.
  • Bachelor's degree in a related field or equivalent experience.
  • Proven ability to lead and manage in a Labor/Management Partnership environment.
  • In-depth knowledge of NCQA accreditation and regulatory compliance requirements.

Responsibilities

  • Lead regional Member Services operations with a focus on member engagement.
  • Develop and implement strategic plans to enhance member services.
  • Oversee day-to-day operations and ensure regulatory compliance across medical centers.
  • Drive internal initiatives to improve service quality and member satisfaction.
  • Collaborate with local leaders to streamline complaint resolution processes.
  • Manage performance measurements and best practices across the region.
  • Foster relationships with executives and stakeholders to optimize service delivery.

Benefits

  • On-site work, with opportunities for hybrid work arrangements.
  • Engagement in a dynamic Labor/Management Partnership environment.
  • Access to a supportive and collaborative leadership structure.
  • Focus on professional growth through strategic program management.
  • Opportunity to impact member retention and service quality on a regional scale.
Full Job Description
This Senior Director of Regional Member Services will be on site most days in one of the following sites: Anaheim, Irvine, South Bay, Baldwin Park, and Downey.
Technical Summary:
The Senior Director of Member Services leads regional operations that deliver highly responsive, proactive engagement for members and patients across multiple service areas. This role drives key initiatives that strengthen retention, support Medicare 5-Star performance, reduce experience friction, and increase likelihood to recommend Kaiser Permanente. The leader provides strategic direction and oversees day-to-day Member Services operations in medical centers throughout the region, while also supporting service area executives with escalations and incident management.
Job Summary:
Provides strategy and direction to the Member Services function with overall responsibility for the day to day local Member Services operations in medical centers throughout the region.

Essential Responsibilities:
  • Provides strategy and direction to the Member Services function across the NCAL or SCAL region.
  • Develops and executes strategic plans, policies and objectives with long term, region wide impact to the Member Services function.
  • Establishes and executes goals and processes.
  • Identifies and drives internal initiatives to improve overall quality performance in Member Services.
  • Has region wide control of the planning, staffing, budgeting, managing expense priorities, and performance requirements.
  • Oversees the day to day operations in the local medical centers throughout the region to ensure member satisfaction and compliance with ongoing regulatory requirements.
  • Manages programs to ensure survey readiness for the Member Services function.
  • Partners with leaders in the local medical centers to ensure the implementation of complaint resolution processes and procedures in the medical centers within and across medical centers.
  • Works with peers from Member Services and Member Correspondence Center in ensuring integration of the major components of statewide and national share support operations.
  • Oversees key operational relationships between NCAL and SCAL Permanente Medical Groups in efforts to achieve quality outcomes and maintain ongoing regulatory compliance.
  • Develops and executes best practices for performance measurement.
  • Partners with executives from NCAL KFH/HP, TPMG and SCAL Permanente Group (SCPMG) to ensure leveraging of capabilities and sharing of statewide best practices.
  • Leads teams through large strategic process improvements and change efforts in the medical centers both at the region wide or local levels.
  • Collaborates with Sales, Marketing and medical center leaders to improve member retention, affect growth and improve purchased group satisfaction.
  • Kaiser Permanente conducts compensation reviews of positions on a routine basis.
  • At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status.
  • Such changes are generally implemented only after notice is given to affected employees.
  • Consistently supports compliance and the Principles of Responsibility (KPs code of conduct) by maintaining confidentiality, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal and State laws and regulations, accreditation and licensure requirements, and KP policies and procedures.
  • In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives.
  • Accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.
Basic Qualifications:
Experience
  • Minimum seven (7) years senior management/leadership experience in health care managing multiple locations.
  • Minimum five (5) years of experience in a complex healthcare (HMO) environment.
Education
  • Bachelors degree in Health Care Administration, Business or Public Health Administration, Operations Research, Economics or other related field, OR four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.
License, Certification, Registration
  • N/A
Additional Requirements:
  • Must be able to work in a Labor/Management Partnership environment. Proven ability to lead and manage through influence and change; implementing strategic changes.
  • Proven capability to motivate change and galvanize action through synthesis and interpretation of outcome data.
  • Demonstrated background in strategic thinking and implementation.
  • Proven ability to balance execution of the strategic vision through leadership and delegation, with a willingness and competence to dive into the details as required.
  • In-depth knowledge of, and leadership experience with, KP Program requirements for NCQA Accreditation and regulatory compliance.
  • Leadership experience working with regulatory agencies and dealing with integrated care delivery systems and coordinated care issues.
  • Successful experience managing a broad range of operational and organizational redesign, improving internal operations, financial turnaround, creating a performance oriented organization, and change management.
  • Demonstrated expertise in project management, problem solving, verbal and written communication and collaborative working skills.
  • Excellent interpersonal skills (negotiation, listening and communication skills) characterized by effective interactions with a diverse range of internal and external constituents, stakeholders and audiences.
  • Demonstrated political savvy -- able to operate in politically complex situations and remain effective.
  • Demonstrated ability to function collaboratively in a multi-entity partnership environment.
  • Demonstrated leadership capabilities, including but not limited to developing dynamic, constructive working relationships and partnerships with operational, physician and administrative Leaders.
  • Proven ability to develop dynamic, constructive working relationships and partnerships with operations and physician partners.
Preferred Qualifications:
  • N/A.


Primary Location: California,Anaheim,Orange Co Anaheim Medical Center
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, 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-SCAL-01|NUE|Non Union Employee
Job Level: Director/Senior Director
Department: Regional Offices - Pasadena_I228_TEST - Mbr Svc-Member Relations - 0801
Pay Range: $151200 - $195580 / 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, 50 % 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.

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