Assume the role of Regional Quality Improvement Program Manager for KPNW. Assure compliance with CMS contractual and regulatory requirements for quality improvement at both the federal and state levels, as well as with other accreditation and regulatory agencies, by providing planning, leadership, and management of health plan quality assessment and performance improvement (QAPI) activities. Review and assess the success of regional QI projects and programs aimed at enhancing KFHP members' health and safety. assist in performance improvement by trending and analyzing data from clinical data, occurrence reports, satisfaction surveys, and usage statistics. Together with leaders in KFHP, KFH, and NWP quality and service improvement, identify, launch, and promote the effective completion of performance improvement programs.

Significant Duties:

Use the proper performance improvement models, processes, and tools to address opportunities under the purview of KFHP Quality and Service and NWP Quality and Systems while managing and facilitating a portfolio of multidisciplinary projects and initiatives throughout the area. These initiatives are intricate, diverse, and very visible for the organization in terms of compensation for performance and reputation. Determine organizational risk or the impact of performance gaps or noncompliance and communicate it to department and organizational leaders. Recommend regional strategies for improvement or resolution to the department and organizational leaders, using innovative systems thinking and evidence-based strategies when possible.

Serve as a consultant and facilitator when putting improvement initiatives and plans into practice; make sure projects are adequately planned and organized to produce outcomes while preserving the ownership of the processes by operational or business executives. To meet regulatory and accrediting standards as well as to inform KPNW senior leaders, perform sophisticated problem-solving and systems analysis, build process and outcome measures of effectiveness, document efforts and results, and create/submit reports. Promote understanding and agreement among stakeholders at all levels of the company, successfully influence without formal authority, and negotiate for the resources required to remove obstacles to improvement or program effectiveness.

Prepare and submit documentation proving adherence to internal and external regulatory requirements as well as accreditation standards. Also, prepare materials and reports for audits and provide appropriate corrective action plans in response to audit findings, making sure these are built to be successfully implemented and maintained. Assume the role of content and subject matter expert for a number of quality-related Medicare contract requirements, such as value-based incentive schemes and patient safety event reporting and billing procedures.

Work together on improvement initiatives with regional and Kaiser Permanente Program Office partners. Organize the region's efforts to work together on optional or required projects with community health partners (state and federal offices, and quality improvement organizations, or QIO).

In order to achieve program excellence, work with medical professionals, managers, directors, professional staff, and senior leaders to identify best practices and design, measure, and put into effect appropriate solutions.

Work together with supervisors, colleagues, and the KP corporate program office to develop and document the comprehensive KPNW Quality Program, which is distributed to both internal and external audiences, including members, brokers, regulatory and accreditation organizations, and the KFH and KFHP Boards of Directors.