Sr IT Director, Utilization Management & Complex Care Management

Upon start, selected candidate must reside in CA, CO, GA, HI, MD, OR, VA, WA, or District of Columbia. Please also note, this position may require reporting to the office up to 2-3 days per week.

Technical Summary

The Sr Director will lead Utilization Management and Complex Care Management capabilities across the KP Enterprise under CDTS Acute, Outpatient, and Complex Care Product Portfolio. This role is critical in driving strategic transformation, operational excellence, and clinical integration to support high-quality, cost-effective, and patient-centered care. The scope of work spans across Epic projects, non-Epic projects, and other related work in partnership with Health Plan, PMG, and other IT teams. Strategic Leadership: Oversee enterprise initiatives including CMS 2.0 Unified Authorization, UM Optimization, and Care Coordination, including Medicaid Regulatory enhancements. Lead cross-functional teams to align UM/CM operations with evolving regulatory and clinical priorities. Cross-Functional Collaboration: Partner with Program Managers, Architects, and Clinical Leaders to support shared responsibilities across UM and Care Coordination. Facilitate seamless handoffs and maintain shared accountability for strategic deliverables. Works closely with HP, Physician Groups, CRM, and other IT team across the enterprise. Governance: Drive and maintain KP's Enterprise Care management and Utilization Management Roadmaps. Develop Objectives and Key Results (OKRs) and co-lead the Care Management Product Group Council. Prioritize net-new and backlog demand. Will lead direct and indirect reports (squads).

Job Summary

This senior director role is primarily responsible for directing team(s) in defining product strategy and vision, overseeing product roadmaps from ideation to launch across multiple functional areas, and driving and approving decisions on new products or enhancements to bring to market. This includes reviewing and selecting business cases for new products, improvements to existing products, and/or business ventures; defining, overseeing, and avoiding technical debt; providing direction and oversight to product team(s) and influencing diverse stakeholder groups across the organization throughout the product management life cycle, and building and leveraging partnerships with operations teams and market stakeholders to support product adoption. This role is also responsible for directing internal and external discovery for new and existing products; overseeing end-to-end prototyping and validation with end users; ensuring learnings are funneled to product roadmaps; overseeing the ongoing tracking of outcomes, financials, and key performance indicators; and directing and overseeing product teams to ensure the resolution of complex or high impact user problems.

Essential Responsibilities

• Oversees the operation of multiple units and departments by identifying customer and operational needs; analyzing resources, costs, and forecasts and incorporating them into business plans; engaging strategic, cross-functional business units to champion and drive support for business plans and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring progress; anticipating and removing obstacles that impact performance; addressing performance gaps and implementing contingency plans accordingly; ensuring products and/or services meet customer requirements and expectations while aligning with organizational strategies; serving as a subject-matter expert and trusted source to executive leadership; and providing influence and consultation in the development of the larger organizational or business strategy.
• Models and drives continuous learning and maintains a highly skilled and engaged workforce by aligning cross-functional resource plans with business objectives; overseeing the recruitment, selection, and development of talent; motivating and empowering teams; building organizational capacity and grooming high potentials for growth opportunities and advancement; staying current with industry trends, benchmarks, and best practices; providing guidance and leadership when difficult decisions need to be made; and ensuring performance management guidelines and expectations drive business needs.
• Directs team(s) in defining product strategy and vision, and oversees product roadmaps from ideation to launch across multiple functional areas by driving and approving decisions on new products or enhancements to bring to market; reviewing the evaluation of potential business process changes, system impacts, and flow concepts to determine the viability of implementing desired enhancements; ensuring the provision of an end-to-end holistic view of how specific business processes and internal system configurations impact the user experience; reviewing and selecting business cases for new products, improvements to existing products, and/or business ventures; defining, overseeing, and avoiding technical debt as appropriate; managing product and operational budgets; ensuring documentation clearly communicates customer/stakeholder needs to the product team; and partnering with team members to clarify features and requirements as necessary.
• Provides direction and oversight to product team(s) and influences diverse stakeholder groups across the organization throughout the product management life cycle by driving the resolution of inter-squad, cross-product and external dependencies, roadblocks and constraints; building and leveraging partnerships with operations teams and market stakeholders to support product adoption; overseeing the development of strategic training efforts to build readiness for production support and operational readiness teams; leading feature demos for executive stakeholders; providing advanced product expertise, peer training, and consultation as appropriate; ensuring adherence to enterprise compliance standards; and managing technology risks as appropriate.
• Directs the internal and external discovery for new and existing products by leveraging partnerships with key stakeholders to identify business needs; ensuring the identification and selection of best in class marketplace innovation; overseeing prototyping and validation with end users with support from UX design and research, engineering, and other stakeholders as appropriate; and ensuring learnings are funneled to the product roadmap.
• Oversees the ongoing tracking of outcomes, financials, and key performance indicators by reviewing KPIs and performance metrics (e.g., speed, quality, etc.); reviewing key metrics and verifying KPI alignment; and directing the development and maintenance of ad hoc reports, status updates, and presentation decks for key stakeholders and executive leadership.
• Directs and oversees product team members to ensure the resolution of user problems for complex and high impact issues by ensuring the work backlog is prioritized and balanced across new development, non-functional requirements, and technical work (e.g., maintenance, support, technical debt, etc.); and overseeing competitive and user research/testing, experimentation, and design thinking initiatives.