Executive Director, Actuarial Services
Title: Executive Director, Actuarial Services - Lead Medicare Actuary
Location: California-Oakland-Kaiser Center 300 Lakeside St.
No matter what your job title, the work you do at Kaiser Permanente supports the health and well being of our
members. All 8.7 million of them. That’s because each of us—from our financial professionals and IT team
members to our RNs and physicians on the front line of care—shares a commitment to providing the best
possible care experience. With locations across the United States, we offer the opportunity to build a
rewarding career in an environment that supports your success. Join us and put your beliefs into practice.
The lead Medicare actuary for Kaiser Permanente is responsible for leading the actuarial analysis that
supports the Medicare Business Line. The successful candidate will provide thought leadership and critical
engagement with stakeholders and analytic input to support the development of KP's Medicare strategy.
The preferred candidate will be a bright, seasoned, and highly qualified Medicare actuary. The ideal
candidate's management style will exhibit integrity, collaboration, flexibility, and a result-orientation.
• Lead the KP Medicare bid submissions (117 Part C and D bid submissions for 2011), and manage the
responses arising from the CMS desk review process.
• Act as the "actuarial spokesperson" of KP Medicare with CMS Office of the Actuary and Association of Health
• Evaluate, analyze, and provide strategic analytic direction for Kaiser Permanente's Medicare Line of Business.
• Recommend changes to KP senior leaders that are consistent with KP's long and short-term business
needs, including evaluating market trends, and working closely with finance to project the future needs of KP.
• Responsible and fully knowledgeable of all legislation and regulatory authority affecting KP's Medicare
products. Evaluate and develop recommendations to senior management regarding responses to new
• Provide expertise to regions in development of strategies for margin and membership for both Group and
Individual Medicare offerings.
• Improve Part D process and accuracy for bidding, budgeting, forecasting, and reconciliation.
• Collaborate in developing and implementing national guardrails for Medicare Advantage (MA), and Medicare
Cost premiums and benefits.
• Oversee the development and implementation of KP's Group Medicare rating methodology.
• Manages peer review guidelines and their implementation in KP's Medicare bid submissions across all bids
to ensure accuracy and consistency.
• Negotiates with CMS and their consultants to approve KP bids such that KP will meet membership and
• Assist in developing CMS revenue payment forecasts for short-term (rate setting) and long-term (strategic
• Develop KP CMS MA payment impact scenarios based on different government proposals.
• Support regional efforts to understand the impact of moving from Medicare Advantage to Medicare Cost and
from Medicare Cost to Medicare Advantage, where applicable.
• Manage a staff of 2 actuaries providing national support, as well as indirectly manage the regional actuarial
teams that provide Medicare bid development for each of KP's eight regions.
• Bachelor's degree in mathematics, actuarial science, business, finance, economics, or equivalent.
• Associate of the Society of Actuaries (ASA) is required and Member of the American Academy of Actuaries
(MAAA) is required.
• Minimum of 15 years of combined experience in healthcare pricing and actuarial with a demonstrated and
successful leadership track record in large complex organizations.
• Minimum of 5 years in a lead Medicare function required.
• Commensurate prior experience that demonstrates leadership in developing and implementing strategic
initiatives across a very large, decentralized organization using highly leveraged work teams comprised of
internal and external staff.
• Demonstrates Core Behaviors: Focuses on the Customer, Collaborates, Takes Accountability, Drives for
Results, Communicates Effectively, Champions Innovation and Change, Develops Self/Others, Menu
Behaviors: Thinks and Acts Strategically, Exerts Influence, Demonstrates Business Acumen, Makes
Effective Decisions, Solves Problems through Planning and Analysis, Leverages Technology, Demonstrates
Resource Stewardship, Demonstrates Creativity, Pays Attention to Detail, and Deals with Ambiguity.
• MBA or related graduate degree highly preferred.
• Fellow of the Society of Actuaries (FSA) preferred.
Marketing Services Consultant
Title: Marketing Services Consultant
Location: California-Oakland-Kaiser Center 300
No matter what your job title, the work you do at
Kaiser Permanente supports the health and well-
being of our members. All 8.7 million of them. That’
s because each of us—from our financial
professionals and IT team members to our RNs
and physicians on the front line of care—shares a
commitment to providing the best possible care
experience. With locations across the United
States, we offer the opportunity to build a
rewarding career in an environment that supports
your success. Join us and put your beliefs into
The Marketing Services Consultant serves as the
primary point of contact for a variety of promotional
initiatives generated from various business
partners. Business partners include Marketing
Leadership, Strategic Marketing Consulting,
Service Area Managers, Executive Directors, Public
Affairs Directors and Area Directors of Account
Management (ADAMS). The consultant determines
"best practice" promotional approaches for stated
business problems, which may include referral to
Strategic Consulting for resolution or participating
on a cross-functional team led by a Strategic
Serve as intake advisor for assigned
business partners, recommending
strategic, programmatic, cost effective
solutions for a business problem
requiring promotional support by
accessing established or newly created tools.
Help Strategic Consulting drive local market and
health plan tactical plans through the creation of
marketing materials with relevant leaders in both
California and ROC areas.
Develop and maintain in-depth knowledge base
for "best practice" marketing communication
resources available across multiple marketing
functions including advertising, brand creative,
product marketing, and strategic consulting.
Proactively leverage existing and new marketing
materials to further integrate the marketing
communications experience for targeted
audiences across channels.
Develop and execute creative briefs in association
with end-to-end creative development process,
overseeing all aspects of the development and
production process, including business partner
Develop and manage the marketing
communications content, accuracy, and alignment
with the strategic direction of a health plan
program or medical service.
From a regional base, build relationships of trust
and partnership with local market or regional
leaders through periodic face to face or phone
Serve as the marketing communications liaison
for third party relationships with external vendors
who support both local and regional programs
Bachelor's Degree or equivalent experience.
Minimum 4 years business to business and/or
consumer marketing experience in roles with
Demonstrated experience in positioning and
packaging marketing communications against a
designated strategic direction across a range of
channels and vehicles.
Demonstrated ability to communicate technical
messages and translate them into business-level
Demonstrated ability to lead professionals and
manage others through influence and
Experience developing message content and
creative concepts from a focused strategy.
Project management skills and experience with a
wide range of projects, including some complex.
Strong presentation skills .
Excellent verbal and written communication skills.
Excellent collaboration and facilitation skills.
Master's Degree 2 years related experience.
6 years experience preferred.
What Do Kaiser Permanente and Verizon Have In Common?
By Lisa Engles
August 19th, 2011
It's so inspiring to see tens of thousands of Verizon workers on the East Coast fighting for
their rights and their future. I know exactly how they feel. Verizon, sadly, isn't the only huge,
brand name corporation that's trying to cut workers' healthcare benefits at a time of record
profits. One other company acting like Verizon is none other than a non-profit healthcare
provider -- my employer, Kaiser Permanente.
As a healthcare worker, I never imagined I might not be able to go to the doctor myself. I
never believed I might not be able to afford a surgery or be afforded the care I give to
patients every day. I have dedicated my life to helping people receive the care they deserve.
After all, I work for one of the largest, most successful healthcare organizations in existence!
But here's the side of Kaiser Permanente you don't hear about from their glowing reports:
Kaiser executives are currently trying to strip the workers of our future by cutting our health
coverage and reducing our retirement benefits. Their idea of “cutting the fat” means cutting
out the people who care directly for patients. Short staffing is now the norm, instead of the
exception. Short staffing means our patients don’t get the care they deserve.
The thing is, like Verizon, Kaiser is profitable. Kaiser made over $1.5 billion in profits in the
first six months of this year alone. They aren’t hurting in the least. There might be a
recession, but it sure isn’t evident from Kaiser's corporate profits.
And now, Kaiser is raising rates on thousands of California teachers, who are already
severely affected by cutbacks and layoffs. These folks, who are responsible for educating our
youth, will have an even harder time keeping their jobs while their school districts have their
budgets strained even more than they already are to beef up Kaiser's profits. All because
people like George Halvorson are GREEDY and think they are entitled to MORE. More
money, more pensions, Better Health Coverage, the list goes on...
As I said, there may be a recession, but it’s not evident at the top levels of Kaiser. Kaiser's
CEO, George Halvorson, has EIGHT – yes you heard right – eight pensions! His golden years
really will be golden. He can rest easy knowing he has the Cadillac of health plans to help
keep him healthy while he spends all that money...
Lisa Engles is a Medical Assistant at Kaiser Roseville in California and a rank-and-file
member activist in the National Union of Healthcare Workers
Underwriting Manager - Individual Product Line
Kaiser Permanente Health Plan - Buckhead (Greater Atlanta Area)
The KPIF Underwriting Manager’s primary responsibility is to provide direction and
leadership to the underwriting staff. This work requires strong management and
communication skills, an excellent understanding of underwriting concepts, and the ability
to assess market and competitive position. Activities managed include operational
processes, and implementation of policy and process improvements. This position
partners with KPIF line of business and sales leadership to evaluate market dynamics
and to implement strategies that will maximize growth while mitigating financial risk.
• Manages the efforts of direct and indirect reports, and collaborates with, provides
guidance to and influences employees, clients and business partners.
• Responsible for selecting, developing, and deploying staff in the most effective manner
to meet assigned objectives.
• Responsible for performance management, compensation decisions, rewarding and
recognizing employees, and providing on-going, regular performance feedback.
• Establishes departmental strategy and tactics, and contributes to operational area’s
strategy formulation and execution.
• Coordinates planning activities with team members to accomplish goals, allocate
resources and track results.
• Determines objectives and sets priorities; anticipates potential threats or opportunities
and vets them within the organization.
• Ensures that effective controls are developed and maintained to ensure the integrity of
production outcomes for the department. Takes corrective action as appropriate.
• Initiates and evaluates business process improvements in order to achieve business
results and appropriate solutions for customers.
• Uses efficient and cost effective approaches to improve results and efficiency by
implementing new processes and technology.
• Formulates effective strategies consistent with the objectives of the organization and
• Builds collaborative relationships with internal and external partners.
• Manages a culture of collaboration and accountability between sales, line of business
leadership, customer service, underwriting and other key internal partners.
Desired Skills & Experience
7 years experience - healthcare industry, underwriting, business analysis, market place
Bachelors in Finance,Business or related field.
Proven track record of process and workflow improvement.
Direct management of a team - preferably in an underwriting department.
No third party consideration.
Kaiser Permanente operates as a nonprofit health organization in the United States. No
matter what your job title, the work you do at Kaiser Permanente Georgia supports the
health and well-being of our Atlanta-area members. That’s because each of us-from our
regional professionals to our clinical staff on the front line of care - shares a commitment
to provide the best affordable health insurance and medical care experience. Come build
a rewarding career in an environment that supports your success. Join us and put your
beliefs into practice. Presently Kaiser Permanente GA has 28 medical centers in the metro
Atlanta area with Athens and two 23 hour comprehensive centers being built.
August 22, 2011
Employer Job ID:
September 1, 2011
Permanente’s Model of
and Unit-Based Teams
Kaiser Permanente News Center
The Aug. 30 edition of Human
Resource Executive Online
features an article by Barbara
Grimm, senior vice president,
Office of Labor Management
Partnership, and John August,
executive director of the
Coalition of Kaiser Permanente
Unions. The article, “A Strategy
for Employee Engagement and
describes how unit-based
teams are advancing Kaiser
Permanente’s strategy for
frontline engagement and
Labor Management Partnership
Grimm and August outline three
practices, based on the work of
UBTs, that can help other
organizations engage their
Empower the workforce to make
Identify and support the
essential attributes of
Disseminate effective team
practices throughout the
organization and integrate them
into day-to-day operations.
The article includes examples of
UBT success, shows how teams
align their performance
improvement goals with the
larger strategies of the
organization, and highlights
Kaiser Permanente employees’
industry-leading levels of
Human Resource Executive
Online is the Web-based
version of Human Resource
Executive magazine, aimed at
HR directors and vice
presidents across all industries.
Human Resource Executive
Online reports that it gets more
than 15,000 unique visitors per
For more about Kaiser
Management Partnership, go
"The bottom line is we don't have enough staff," she said, adding
that Kaiser recorded a $1.6 billion profit for the first six months of
2011. "With profits like these, Kaiser can provide staff to see
patients in a timely and ethical manner.
Sutter, Kaiser nurses go on strike
By Melissa Murphy
The Reporter (Vacaville)
...Kaiser Permanente nurses -- who are represented by the California Nurses Association and have settled
their own contract -- said they were striking for their own reasons and not out of sympathy for Sutter nurses.
It just happened that on the same day Sutter nurses staged a one-day walkout, Kaiser nurses took a
supportive stance for Kaiser mental health workers, about 1,500 of whom are represented by the National
Union of Health Care Workers (NUHW) in Northern California, said Brenda Tolbert, a marriage and family
therapist with Kaiser.
"They are not striking their own contract," Tolbert said. "The nurses are here to support
the mental health workers. We wanted a stronger voice to protect our patient care."
In a letter to Kaiser nurses printed in The Reporter and other newspapers, Northern California Regional
President Gregory Adams and Executive Medical Director Robert Pearl asserted that Kaiser is bargaining
with NUHW in good faith.
They also noted the agreement with the nurses represented by CNA states, "There shall be no strikes,
lockouts or other stoppages, or interruptions of work during the life of this agreement."
Tolbert said hundreds of people stood unified at the corner of Vaca Valley Parkway and Quality Drive in
Vacaville on Thursday. Some 50 were mental health workers, the others were nurses who walked off the job
and chose not to be paid that day.
One reason for the strike, Tolbert explained, is to stand up for better patient care.
She added that patients have to wait five to six weeks for an appointment when
state law says it should be only up to a two-week wait.
"The bottom line is we don't have enough staff," she said, adding that Kaiser
recorded a $1.6 billion profit for the first six months of 2011. "With profits like these,
Kaiser can provide staff to see patients in a timely and ethical manner.
"We helped Kaiser earn this money, we should be rewarded for it."
At the picket line in front of Kaiser in Vacaville, Aretha Franklin's song "Respect" played on
loud speakers, followed by Tom Petty's "Won't Back Down." Dressed in red T-shirts, union
members and nurses waved signs that read "Some Cuts Don't Heal," "Fair Contract Now" and
"Kaiser is Not Thriving."
Other reasons for the strike include changes to a health plan and retirement packages. Some
of those changes will occur in 2013, others in 2014.
Sitting in the shade on the picket line, Rivka Kaplowitz explained that she has been a
psychologist with Kaiser for 15 years and she is shocked the health-care provider wants to
eliminate benefits for her husband. Kaiser also has proposed giving her only $100 per month
toward health-care benefits, she said.
"Who will take me at that rate? They sure won't take me," she said as she pointed to the
Kaiser hospital in Vacaville. "I don't get it. You're a health-care provider and you're cutting
health care? It doesn't make sense."
As a psychologist, it pains Kaplowitz to see her patients only once every six weeks.
"It's good therapy to see them more often," she said. "I love my job and my patients. The work
we do is essential."
Roy Chaffee works at the Kaiser call center in Vallejo and decided to support the NUHW strike
in Vacaville even though he is represented by a different union. He said if Kaiser is willing to
attack the smaller unions with huge cuts, it's only a matter of time before the bigger unions will
see cuts, too. "These cuts are absolutely crazy," he said. "It's unnecessary and
unprecedented. We're standing up for the patients; we're not going to sit idly by."
Chaffee said the union and those supporting its members want to keep fair wages and
health-care benefits in place and protect the staffing numbers. He added that Kaiser's profits
should be reinvested in the organization.
The morning wasn't without confrontation.
Before the strike started, CNA Chief Nurse Representative Melanie Alvarado said she tried
to speak to the nurses on the night shift, to see that all patients were handed over
to other certified nurses called in to relieve the Kaiser nurses.
"They prevented me from speaking to my nurses," she said. "They're not allowed to
Alvarado, who is a Kaiser charge nurse for adult and family medicine, said the union
will likely file a complaint against Kaiser because of that action.
Nearly 200 nurses between the Kaiser location in Vacaville and the satellite clinic in Fairfield
walked off the job to join picket lines.
Alvarado said that, although CNA members have a good contract with Kaiser, they believe the
health-care provider is picking on a little guy.
"There is no reason to do this," she said of the cuts.
in union slugfest
Sal Rosselli, others
ordered to pay $57,000
+ in legal fees for
‘frivolous’ SEIU lawsuit
October 5, 2011
early version of this
blog post incorrectly
stated that the National
Union of Healthcare
Workers was a party to
the lawsuit. That is
president and other
NUHW leaders and
staffers, but not the
union itself. An SEIU
press release included
The president of the
National Union of
and other plaintiffs
affiliated with the union
have been ordered to
pay nearly $58,000 in
legal fees following the
dismissal of a lawsuit
against the Service
deemed “frivolous” by
a Superior Court
judge, SEIU said
Superior Court Judge
Harold Kahn made the
ruling Oct. 3, in the
SEIU, its Oakland-
West local, former
SEIU national leader
Andy Stern, UHW
Regan, and several
other SEIU officers.
But the Superior Court
ruling didn't give SEIU
everything it had
plaintiffs to pay for the
expenses, but only 35
percent of the
attorneys' fees they
Sal Rosselli, NUHW's
president said SEIU's
Oct. 4 statement was
"a lie," because it
indicated NUHW was
affected by the Oct. 3
ruling, when it actually
affects him and other
plaintiffs as individuals.
The two unions have
been at loggerheads
since early 2009, when
ousted longtime UHW
leader Rosselli formed
NUHW and immediately
started a campaign to
lure SEIU workers to the
nascent union. In a key
battle, the two are
fighting for the right to
workers at Kaiser
Permanente , a
convoluted dispute in
which UHW bested
NUHW in fall 2010
balloting, but may be
forced into a re-do
election by the National
Labor Relations Board.
SEIU Threatens To Dissolve CKPU
December 8, 2009
The Coalition of Kaiser Permanente Unions is the group of unions that, along with KP
management, make up the Labor-Management Partnership which was so instrumental in
bringing KP up out of the ashes of the strikes in the late 1980's. SEIU is evidently so afraid
of losing its monopoly position within KP that they are threatening to sunder the entire
coalition, rather than to admit NUHW as a member in that coalition...
Now facing an election they spent millions of dollars to block, SEIU officials are circulating an
email threatening to break up the Kaiser Coalition if the professional chapters vote to
maintain their autonomy by joining NUHW.
Their threat is nothing but a last-ditch effort by Washington, D.C. officials who prioritize their
own personal power over the needs of healthcare workers like us. And that's exactly why we
SEIU knows that when Kaiser professionals join NUHW, the rest of the Kaiser employees will
follow, because our chapters have always led the way in achieving the highest wages and
benefits. We will continue the rich history of our chapters in NUHW with the people who have
been working with us side-by-side on our professional practice issues for years.
In less than a year since SEIU took over, they've given away part of Kaiser workers' pension,
agreed to eliminate 1,800 jobs, and gutted the Labor/Management Partnership by removing
virtually all of the elected stewards and other members who served on LMP committees.
We're voting NUHW to put an end to these divisive tactics, protect our wages and benefits
and our April wage increase, and restore democracy and integrity to our union. We won't let
SEIU keep tearing down our contract and we won't let them break apart the Coalition.
One of the members of the SoCal KP units wrote a letter to the Executive Director of the
CKPU regarding SEIU's threat...
I am a Kaiser employee, Clinical Psychologist, and currently a UHW member. I have been
very involved in LMP as a UBT member both locally and regionally, LMP co-lead, and
trained LMP facilitator, and highly value the LMP process. I received your statement today
from the CKPU regarding membership to CKPU and participation in LMP.
Firstly let me say that I have always respected your work with Kaiser and LMP. You have
done wonderful things in the past to bring employees and managers together to discuss
ways to make Kaiser the best place it can be for our health plan members and for
Today however I am very disappointed with your statement and decision. I certainly do
understand that Andy Stern is the head of CKPU and you are under his employ, and as
such are in a difficult position to follow his demands or lose your job.
You should know that we as members ARE supporting NUHW and WILL win our
decertification vote because we have been very disappointed with the direction Andy Stern
and the UHW trustees have taken our union and do not agree with their policies, corporate
unionism, and back-door deals with management.
I am very disturbed that you do not support our members' right to determine which union we
want to represent us. You are threatening that if we choose NUHW through a federal legal
process, exercising our rights, that you will not allow us to be part of CKPU or LMP.
Is not a union made up of it members and members voices? Is not unionism a democratic
process where we as members have a right to take their union in the direction we feel is best
for us and for those we serve? Does not LMP consist of union members (no matter which
union) working together with management for the good of all?
I just don't understand how banning NUHW from participation does anyone any good. It does
not benefit CKPU, LMP, Kaiser, or any of the other unions in the coalition. It is simply one
more of Mr. Stern's scare tactics to not lose his union members.
As of today I have lost all respect for you and see now that you are simply a puppet in Mr.
Stern's hands to manipulate and carry out his agenda within Kaiser. I don't think you
understand that you are dealing with intelligent, highly educated professionals within these
three professional bargaining units, who are not going to be fooled by SEIU (and now CKPU)
propaganda and will not fall to your threats.
Charlie Morgan, Ph.D.
Kaiser Permanente San Diego
Should you wish to amend Charlie's excellent letter, Mr. August can be contacted by E-mail
Posted by SierraSpartan at 8:18 PM
Does anyone know who the "mr August" addressed in the letter is? Background?
December 9, 2009 6:24 AM
SEIU's threat to break up the Kaiser Coaltion is another example of just how desperate and
anti-union this once vibrant and ethical union has become.
I commend Clinical Pyscologist, Charlie Morgan, for his excellent letter to Mr. August
regarding SEIU's decision to break up the Kaiser Coalition. And of course it's true that the
KP professionals in Southern California are not only intelligent, they have already essentially
decided to choose NUHW as their union representative. It doesn't matter that SEIU continues
to make empty threats whenever their authority is challenged. These professional workers
will win the election once it is scheduled.
NUHW rising! UNITE HERE rising!
December 9, 2009 11:24 AM
Market Planning Consultant
Kaiser Foundation Health Plan - Cleveland, OH
(Cleveland/Akron, Ohio Area)
Work with the Director, Product and Marketing
Planning and the Director, Sales and
Marketing Strategy to analyze market trends
to recommend the marketing (4Ps)
strategies for new member growth and
retention for Kaiser Permanente of Ohio.
Actively participate in the annual rate-setting
process, develop and implement line of
business strategies, build knowledge to define
addressable market, and represent the
Marketing Sales and Business Development
(MSBD) department on multi-functional
groups. Understand the overall corporation
including Health Plan and Ohio Permanente
Medical Group’s (OPMG) overall strategies
and goals. Ensure critical MSBD decisions
align with the current membership and financial
goals. Maintain familiarity with the Northeast
Ohio market place, which includes a keen
understanding of the competition, the broker
and consulting communities, the prospect
base, existing business, provider community,
and health care reform.
• Market Planning including but not limited to
the development of segment specific strategic
marketing plans, including short term and
longer term goals and objectives
• Represent MSBD on initiatives to ensure that
the marketing perspective is balanced with the
other areas of the organization. Ensure the
marketing strategic plan is carried out along
with the overall Ohio strategic plan goals
• Manage MSBD initiatives that require complex
problem solving and the ability to gain buy-in
from many different perspectives to reach
good business solutions
Desired Skills & Experience
• Bachelor’s Degree or equivalent work
experience in selling or managing broker,
employer, and/or consultant relationships in
the health insurance industry
• Seven (7) years experience in managed-care
marketing and/or strategic planning experience
in a health insurance industry
• Must have working knowledge of health
benefits, products and operations
• Familiar with all forms of funding and rating
methods, and the full spectrum of health
insurance products, including HSAs, HRAs,
ASO arrangements, prospective rating and
community rating, and health care reform
• Strong customer, broker, consultant and
• Ohio Life, Accident & Health Variable Product
No matter what your job title, the work you do
at Kaiser Permanente Ohio supports the health
of our Cleveland-area members. Each of us—
from our financial professionals and IT team
members to our RNs and physicians on the
front line of care—plays a vital role in providing
the best possible care experience. Together,
we share a commitment to enhancing the
health and well-being of our members and
communities. Northeastern Ohio is great place
to live and work. At the heart of the region, the
city of Cleveland sits on the shores of Lake
Erie. A melting pot of culturally diverse
neighborhoods, exciting major league sports
teams, and the Rock and Roll Hall of Fame,
Cleveland is also a center for art and culture
with many museums, as well as the renowned
Cleveland Orchestra and PlayhouseSquare.
Come build a rewarding career in an
environment that supports your success.
January 11, 2012
Employer Job ID: