VP, National Medicaid Finance

The person filling this role is an influential leader with internal and external constituents and supports the Executive Leadership Team’s decision-making and advocacy regarding Medicaid throughout the Program. She/he provides leadership, technical expertise, and direction for the key accountabilities related to Medicaid initiatives and operations. The incumbent ensures that the functions, systems, and processes are integrated, coordinated, and continually enhanced including Medicaid revenues, regulatory requirements and audits, strategic and financial analytics. The Vice President, Finance Leader - Medicaid contributes to a strong control environment and champions continuous process improvement. This requires influence and strong change management skills to gain buy-in from different constituencies including senior executives in support of future direction. This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state, and local laws and regulations, accreditation and licensure requirements (if applicable), and Kaiser Permanentes policies and procedures.

• Accountable for rate setting and financial reporting in all regions


• Manages Medicaid finance teams in direct contract regions of CA, MD and HI 


• Develops deep understanding of market strategy, capabilities, financial drives, data analytics, financial operations, and metrics.


• Provides leadership in rate setting and risk adjustment activities. 


• Develops and maintains meaningful relationship with state and plan partner finance teams


• Provides overall market profit and loss (P&L) management and leadership with budgets, forecasts, financial analysis, trends, projections, and analytics.


• Responsible for financial analysis, identification of financial drives, and forecasting.


• Responsible for financial reporting to the State regulators and financial audits


• Collaborates with other leaders to develop strategies that optimize Medicaid and “Duals” performance objectives in support of the enterprise.


• Stays abreast of industry trends, the evolving regulatory environment, and internal operational changes to assess risks and opportunities that apply to the Medicaid line of business.


• Partners with operational leaders to ensure that Medicaid performance targets are set, clearly communicated and are aligned with financial targets, forecasts and economic plans.


• Partners with Medicare leaders regarding the performance of “Duals” members to align with overarching operational and financial performance objectives.


• Ensures compliance with regulatory, administrative, and legal requirements by providing leadership, strong technical expertise, and extensive use of analytics to ensure appropriate due diligence.


• Establishes appropriate internal controls to support SOX and Model Audit Rule requirements for the Medicaid line of business.


• Responsible for the integrity of Medicaid and “Duals” financial reporting, economic plan, annual budgets, forecasting, and analysis.


• Serves as liaison with Accounting, Finance, Revenue Management, Medicaid line of business, Compliance, National and Market Health Plan Operations, Government Relations, Legal and other related departments across the enterprise.


• Builds and maintains collaborative partnerships with the markets to assure the success of financial business strategies and to ensure that they complement overall organizational strategies. Serves on numerous cross-functional and special projects and committees involving key leaders.


• Represents Medicaid with internal and external stakeholders, other Kaiser Permanente functions, vendors, and regulatory agencies.


• Recruits, develops, and maintains a high performing, talented, and engaged team. 

This position has a target base salary of $297,000 to $371,250 and is eligible for incentive compensation, an executive allowance, comprehensive health, wellness, time off, savings, and retirement benefits, as well as relocation support, as applicable.