Troy Salley

VP Medicare & Medicaid Membership Administration @Kaiser Permanente

Recruited to lead stabilization and optimization of the health plan enrollment, billing and reconciliation functions supporting Kaiser’s 2.7 million Medicare and Medicaid members. Direct 2 operational teams encompassing 300+ direct and indirect reports. Designed and deployed “Evolving Excellence” business strategy in 2016 which progressively elevated and sustained performance outcomes to often exceed stretch target levels for service level (96%), quality (97%), compliance (100%), Medicare Stars elements (both 5-star) and financial measures. Required significant emphasis on leadership mindset; remediation of system defects; deployment of quality program; redesign of compliance monitoring; and sharpened focus on service intervention and issue resolution approaches. Principal architect of the 5-year “One MA” strategic imperatives strategy deployed to strengthen the collective performance of the national shared service Membership Administration team. Initiated in 2018, it provided a comprehensive framework of 27 imperatives that is delivering bolstered team performance, operating efficiency & capabilities, labor relations, and service experience outcomes. Redesigned, socialized and executed a bold policy change to eliminate the practice of disenrolling Medicare members for failure to pay their individual premiums and shift collection effort towards a model of member assistance & advocacy. Analysis revealed heartbreaking consequences experienced by these members as well as material loss of membership and ~$25m in capitated revenues to KP annually.