Kaiser Permanente
Clinical Consulting Senior Manager - Utilization Management Business Operations
San Diego, CA
Mar 15, 2025
Full-time
Full Job Description
Job Summary:
Manages a team of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive successful initiatives and projects within clinical settings across one or more technical areas or workstreams. Manages the development and implementation of multiple clinical initiatives, systems, and processes to a desired future state. Monitors clinical or care delivery strategy and ensures organizational alignment and prioritization of clinical initiatives by developing and determining goals and priorities with management team sponsors; defining, developing, and evaluating performance metrics. Manages complex, highly visible projects or project components, manages change management activities, and manages team members in performing complex data analyses to drive care delivery or clinical initiatives. Directs vendor management as required. Monitors and takes accountability for compliance of team work activities by ensuring business plans and team members adhere to relevant policies and procedures.

Essential Responsibilities:

  • Creates and advocates for developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works with leaders and employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; hires, trains, and develops talent for growth opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees implementation, adapts, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends; shares best practices within and across teams. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams; motivates teams to meet business objectives. Delegates tasks and decisions as appropriate; provides appropriate support, guidance and scope; encourages development and consideration of options in decision making; fosters access to stakeholders.

  • Manages designated units or teams by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed; partners with key stakeholders and business leaders to ensure products and / or services meet requirements and expectations while aligning with departmental strategies. Aligns team efforts; builds accountability for and measuring progress in achieving results; assumes responsibility for decision making; fosters direct reports to resolve escalated issues as appropriate. Communicates goals and objectives; incorporates resources, costs, and forecasts into team and unit plans; ensures matrixed resources are fulfilling service or performance requirements across reporting lines. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams and units to operate in alignment with operational and business objectives.

  • Manages a team of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive successful initiatives and projects within care delivery or clinical settings across one or more technical areas or workstreams by making significant contributions and/or providing leadership to high visibility projects to identify and resolve issues of strategic importance to the organization; identifying and ensuring representation and inclusion of appropriate stakeholders and team members; building rapport and partnerships with stakeholder teams, third party vendors, and senior/executive management to produce results that are outcome driven; working with stakeholders to set the strategic direction of initiatives, develop goals and set the prioritization of deliverables; discussing involvement of key processes (e.g. quality management, project change management, communication) and facilitating decisions necessary for the delivery of initiatives; communicating tough issues to stakeholders while maintaining an independent perspective; providing expertise and recommendations; developing written materials for senior executives and other key clients; and making formal presentations and providing reports to various senior and/or executive level audiences.

  • Manages a team of consultants in the development of requirements, for complex clinical, process, or system solutions multiple technical area(s) by partnering with senior and/or executive stakeholders and cross-functional teams as appropriate; providing guidance in the use multiple requirements gathering methodologies to identify clinical, functional, and non-functional requirements; monitoring the development and documentation of comprehensive case studies to assess the costs, benefits, and ROI of proposed solutions; collaborating in the development of results-driven action plans; and leading team members in the development process as appropriate.

  • Manages the development and implementation of multiple clinical initiatives, systems, and processes to a desired future state by maintaining an advanced understanding of how current processes impact clinical operations across one or more technical areas; mapping current state against future state processes; identifying the operational impact of requirements on upstream and downstream solution components; providing options and recommendations to senior and/or executive management and clinical stakeholders on how to integrate solutions and deliverables with current systems and processes across regions or technical areas; and identifying and validating value gaps and opportunities for process enhancements or efficiencies.

  • Monitors clinical or care delivery strategy and ensures organizational alignment and prioritization of clinical initiatives by developing and determining goals and priorities with management team sponsors; defining, developing, and evaluating performance metrics, standards, and methods to establish success; partnering with senior and/or executive stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; refining strategic plans and performance metrics as appropriate; and proactively monitors complex initiatives or portfolio to ensure delivery of measurable results and alignment with strategic objectives.

  • Serves as a lead advocate of continuous learning and professional development by keeping abreast of industry practices, standards, and benchmarks; attending and presenting at roadshows, conferences, and speaking events; overseeing the ongoing enhancement and innovation of clinical consulting practices, standards, and methods across KP; serving as an advocate to ensure continuous learning and improvement is championed as a people strategy; and providing ongoing coaching to build a continuous improvement mindset and build capabilities that drive results.

  • Manages complex, highly visible projects or project components by partnering with clinical leadership and key stakeholders; providing guidance on assembling teams based on project needs and team member strengths; overseeing the development, analysis, and management of project plans, including proposed project structure, approach and work plan; negotiating time commitments and resources; coordinating project schedules and resource forecasts; proactively monitoring, identifying, and resolving project or clinical initiative risks, issues, and trigger events; developing mitigation plans and strategies; resolving or escalating risks or issues as appropriate; and providing leadership advice to project teams, as well as managing the work of outside consultants when needed.

  • Manages change management activities associated with care delivery or clinical initiatives by engaging and influencing stakeholders to obtain support and buy in for changes; partnering with senior and/or executive management, project champions, and clinical owners to communicate and align improvement initiatives with strategic objectives; recommending and determining appropriate change management method and approach; and ensuring stakeholders embrace a change management mindset, understand intent and purpose, and foster a culture of change.

  • Manages team members in performing complex data analyses to drive care delivery or clinical initiatives by recommending appropriate data analysis tools and approach to assess performance; empowering team members to utilize suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; and forecasting and alleviating risks through data-driven analysis.

  • Directs vendor management as required by monitoring vendor performance levels; ensuring service level agreements are met; managing vendor invoices; and partnering with Procurement, Legal, and/or clinical leadership teams to develop service level and/or scope of work agreements as appropriate.

  • Monitors and takes accountability for the compliance of team work activities by ensuring business plans and team members adhere to KP, departmental, and/or clinical policies and procedures.


Minimum Qualifications:

  • Minimum five (5) years experience in a leadership role with or without direct reports.

  • Bachelors degree in Nursing, Health Care, Public Administration, Public Health, Statistics, Science or a directly related field and minimum eight (8) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment OR Masters degree in Nursing, Health Care, Public Administration, Public Health or a directly related field and Minimum six (6) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field OR Minimum eleven (11) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field.


Additional Requirements:
  • Knowledge, Skills, and Abilities (KSAs): Business Acumen; Change Management; Negotiation; Business Process Improvement; Creativity; Applied Data Analysis; Financial Acumen; Business Relationship Management; Conflict Resolution; Consulting; Managing Diverse Relationships; Process Validation; Project Management; Risk Assessment; Service Focus; Requirements Elicitation & Analysis

PDN-9e6f4e9d-832c-4b27-b491-ef4d75bda3d1
Job Information
Job Category:
Healthcare Services
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Clinical Consulting Senior Manager - Utilization Management Business Operations
Kaiser Permanente
San Diego, CA
Mar 15, 2025
Full-time
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