CrawlJobs Logo
Healthfirst Logo Healthfirst · IT - Administration

Project Manager- Clinical Transformation

United States Employment contract · Job Posted June 28, 2026
Apply Position
Job Link Share

Job Description

The Project Manager Clinical Transformation (PM) supports the end-to-end coordination and execution of cross-functional initiatives focused on clinical operations enablement, workflow modernization, regulatory readiness, operational adoption, and technology implementation across Healthfirst. The PM is responsible for coordinating clinical project activities, maintaining project plans and governance materials, supporting operational and regulatory initiatives, and driving execution of defined deliverables, timelines, risks, and dependencies. The PM collaborates with clinical, operational, technology, vendor, compliance, and business stakeholders to support implementation efforts for Utilization Management, Care Management, and related clinical operations platforms. The incumbent manages medium-to-large-scale projects with department-level or enterprise-level importance, moderate to high complexity, cross-functional interdependencies, and measurable operational, clinical, or business outcomes.

Job Responsibility

  • Organize and lead project teams through the full project life cycle, from initiation through implementation and stabilization
  • Develop, maintain, and manage project plans, timelines, milestones, meeting documentation, status reports, decision logs, issue trackers, and action-item tracking
  • Partner with clinical, operational, technology, vendor, compliance, and business stakeholders to ensure requirements are clearly understood and implementation activities align with business and clinical needs
  • Translate business, clinical, and operational requirements into executable project plans, deliverables, milestones, and workstream activities
  • Coordinate project execution, resource planning, and cross-functional activities to ensure projects are completed on schedule, within scope, and aligned to budget expectations
  • Maintain project governance materials required for medium-to-large-scale initiatives, including status reporting, risk and issue logs, dependency tracking, and escalation materials
  • Establish and actively manage project stakeholder expectations, relationships, communication rhythms, and accountability structures
  • Monitor and report on project milestones, deliverables, risks, issues, decisions, and dependencies, escalating to leadership as appropriate
  • Manage deliverables across functional teams to ensure outputs meet defined timelines, quality expectations, implementation requirements, and project guidelines
  • Tailor project management methods based on project size, complexity, delivery methodology, stakeholder needs, regulatory considerations, and organizational impact
  • Report project status to project sponsors and leadership, escalating changes, risks, issues, and barriers for resolution as needed
  • Collaborate with resource managers and functional leaders to support appropriate resource planning and project delivery
  • Achieve project objectives in accordance with Healthfirst project management methodologies, standards, policies, and governance expectations
  • Perform additional duties as assigned

Requirements

  • Bachelor’s degree from an accredited institution or equivalent work experience
  • HS Diploma or GED from an Accredited Institution
  • Experience managing cross-functional projects that yielded meaningful results
  • Experience engaging and communicating with key stakeholders including senior-level leadership
  • Experience with project change management, portfolio risk management, project communication management and organization change management
  • Experience managing multiple priorities, coordinating across teams, escalating issues appropriately, and driving project execution in a matrixed environment

Nice to have

  • Master’s degree from an accredited institution
  • Advanced-level certification such as Project Management Professional (PMP), Program Management Professional (PgMP), Certified Professional in Healthcare Quality (CPHQ), or Lean
  • Prior experience leading medium to large scale, clinically focused projects within healthcare or health insurance
  • Demonstrated experience delivering AI-enabled platforms, advanced analytics solutions or new software platforms solutions within healthcare operations
  • Experience supporting technology implementations, application upgrades, platform migrations, system integrations, or operational transformation initiatives
  • Industry work experience in healthcare such as hospital, including managed or long-term care, health insurance, hospital long-term care, government or other healthcare agency
  • Knowledgeable of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations

What we offer

  • medical, dental and vision coverage
  • incentive and recognition programs
  • life insurance
  • 401k contributions
Healthfirst - All Job Offers

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Suggested Tags: Frontend Developer Secretary Talent Manager Salesforce Administrator Data Analyst
Similar Jobs for

Project Manager- Clinical Transformation

8 matching positions

Senior Project Manager of Clinical Transformation

The Sr Project Manager Clinical Transformation (Sr PM) uses their deep knowledge...
Location
Location
United States
Salary
Salary:
105100.00 - 188020.00 USD / Year
healthfirst.org Logo
Healthfirst
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree from an accredited institution or equivalent work experience
  • HS Diploma or GED from an Accredited Institution
  • Prior experience leading medium-to-large-scale, clinically focused projects within healthcare or health insurance
  • Demonstrated experience delivering AI-enabled platforms, advanced analytics solutions or new software platforms solutions within healthcare operations
  • Experience managing enterprise software implementations with vendors, systems integrators, and internal IT teams
  • Experience requiring executive presence to influence decisions and drive alignment across senior leaders and diverse stakeholder groups
  • Demonstrated expertise managing projects with significant operational and technology dependencies requiring analytical, communication, and problem-solving skills
  • Experience applying project delivery methodologies, with proven ability to tailor approaches depending on goals/initiatives
Job Responsibility
Job Responsibility
  • Lead end-to-end implementation of AI-enabled clinical platforms supporting UM, Care Management, prior authorization, population health, or related clinical operations
  • Manage large-scale transformation initiatives involving workflow redesign, system integration, data migration, operational readiness, and change management
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes
  • Manage a high-volume portfolio of large, cross-functional projects with significant operational, clinical, technical, financial, and regulatory interdependencies
  • Translate operational and clinical requirements into executable implementation plans with technology teams and vendors
  • Ensure AI solutions align with clinical operations, compliance standards, audit requirements, and user adoption objectives
  • Partner with executive and senior leaders to drive alignment, facilitate decision making, remove barriers, and ensure accountability across stakeholder groups
  • Standardize and apply project management best practices, tailoring methodologies as appropriate to initiative complexity and scope
  • Establish and maintain project governance structure, including steering committees, status reporting, risk management, and escalation pathways
  • Proactively identify and mitigate risks related to cost, scope, timelines, regulatory compliance, operational disruption, and organizational readiness and adoption
What we offer
What we offer
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Incentive and recognition programs
  • Life insurance
  • 401k contributions
  • Fulltime
Read More
Arrow Right

Interim Project Manager

Are you a Band 8a Project Manager looking for your next NHS contract role? We ha...
Location
Location
United Kingdom , Croydon
Salary
Salary:
33.00 - 35.00 GBP / Hour
https://hg-ahp.com Logo
Hunter Gatherer AHP
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • previous NHS Project Management experience
  • strong stakeholder engagement and communication skills
  • experience delivering transformation or service improvement projects
  • ability to manage multiple priorities in fast-paced NHS environments
  • confidence presenting to senior stakeholders and governance groups
Job Responsibility
Job Responsibility
  • lead end-to-end project delivery
  • manage project plans, milestones, risks, and governance
  • support digital enablement, service redesign, and CIP initiatives
  • engage senior clinical and operational stakeholders
  • present concise updates to governance and decision-making forums
  • facilitate meetings and manage cross-functional collaboration
What we offer
What we offer
  • Fast & simple registration process
  • Reliable, weekly payroll
  • Specialist NHS recruitment consultants
  • Exclusive NHS contract opportunities
  • Long-term contract opportunities
  • Industry insights & market support
  • Fulltime
Read More
Arrow Right

Project Manager - Jr Level

Project Manager Job Summary: The Rural Health Transformation Program – E-Consult...
Location
Location
United States , Nashville
Salary
Salary:
Not provided
dashtechinc.com Logo
Dash Technologies
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Ability to lead complex, multiyear public health programs with clear vision and strategic direction
  • Strong project management skills, including planning, and milestone tracking
  • Excellent written and verbal communication skills, including the ability to translate complex information for diverse audiences
  • Strong facilitation and consensusbuilding abilities across health systems, rural clinics, community partners, and government agencies
  • Ability to lead stakeholder engagement efforts and maintain positive, trustbased relationships
  • Skilled in presenting program outcomes, policy updates, and strategic recommendations to leadership and external partners
  • Understanding of public health systems, primary care, specialty care workflows, and rural healthcare delivery
  • Knowledge of telehealth, care coordination models, and technologyenabled clinical services
  • Ability to analyze and optimize clinical workflows for EConsult implementation
  • Familiarity with interoperability standards (e.g., FHIR, HL7), EHR functionality, and health information exchange
Job Responsibility
Job Responsibility
  • Lead statewide strategy for EConsult adoption to expand access to specialty care in rural and underserved communities
  • Set program goals, KPIs, and success metrics (e.g., turnaround time, consult volume, avoided referrals, provider satisfaction, equity measures)
  • Develop sustainability pathways beyond the 5year grant (e.g., reimbursement strategies, payer engagement, valuebased care alignment, legislative support)
  • Manage federal grant requirements under the Rural Health Transformation Program, including work plans, performance reports, and compliance deliverables
  • Oversee budgeting and fiscal stewardship, ensuring timely procurement, contract administration, and audit readiness
  • Maintain regulatory compliance (HIPAA, 42 CFR Part 2 as applicable, state privacy/security requirements, and federal reporting standards)
  • Coordinate with specialty hubs (health systems, academic centers) to define service lines, turnaround standards, and escalation pathways
  • Develop clinical protocols for appropriateness criteria, triage, documentation, and followup care coordination
  • Implement change management and practice transformation methods to drive adoption and reduce burden on providers
  • Develop training curricula for clinicians, care coordinators, and administrative staff
  • Fulltime
Read More
Arrow Right

Senior Project Manager Utilization Management

The Sr Project Manager (Sr PM) leads large-scale, complex, enterprise transforma...
Location
Location
United States
Salary
Salary:
105100.00 - 188020.00 USD / Year
healthfirst.org Logo
Healthfirst
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree from an accredited institution or equivalent work experience
  • Prior experience leading medium to large scale, complex projects within healthcare, health insurance, or other regulated environments
  • Strong executive presence with the ability to influence decisions and drive alignment across senior leaders and diverse stakeholder groups
  • Demonstrated expertise managing projects with significant operational and technology dependencies requiring analytical, communication, and problem-solving skills
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes for the UM department
Job Responsibility
Job Responsibility
  • Lead end-to-end delivery of complex, enterprise-wide (UM transformation) initiatives focused on operational efficiency, program transformation, technology enablement, and performance improvement
  • Drive UM modernization efforts through implementation of AI, automation, and advanced analytics solutions to improve medical necessity determinations, throughput, and decision accuracy
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes for the UM department
  • Manage a high-volume portfolio of projects with significant cross-functional and technology interdependencies, including operations, clinical, medical management, finance, compliance/regulatory, and IT teams
  • Apply project management best practices, tailoring methodologies as appropriate per initiative
  • Establish and manage project governance, including executive steering committees, decision forums, and escalation pathways
  • Proactively identify and manage risks related to cost, scope, regulatory compliance, operational disruption, and change adoption
  • Track, validate, and report on financial and operational benefits, including cost savings, productivity gains, and return on investment
  • Ensure projects comply with healthcare regulations, internal controls, and quality standards.
  • Drive effective change management to support adoption, sustainability, and realization of UM transformation benefits
What we offer
What we offer
  • medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions
  • Fulltime
Read More
Arrow Right

Project Manager

We are looking for an experienced Project Manager to join our team in Geneva, Il...
Location
Location
United States , Geneva
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Extensive experience managing IT projects at a senior level, with a focus on technology implementations
  • Strong knowledge of Agile Scrum methodologies and practices
  • PMP Certification is highly preferred
  • Proficiency in using project management tools, including Atlassian Jira
  • Demonstrated ability to manage multiple initiatives simultaneously while maintaining quality and efficiency
  • Excellent skills in documentation, governance, and stakeholder communication
  • Proven ability to drive accountability and performance from vendors and teams
  • Familiarity with IT transformations and system implementations
Job Responsibility
Job Responsibility
  • Oversee the planning, execution, and delivery of multiple IT projects, managing scope, timelines, dependencies, risks, and outcomes
  • Provide hands-on leadership and guidance to ensure projects meet objectives and deadlines
  • Develop and maintain project governance frameworks, documentation, and regular status reporting
  • Identify potential risks proactively, escalate issues as needed, and implement mitigation strategies
  • Hold vendors accountable for their deliverables and ensure alignment with project goals
  • Collaborate effectively with clinical, operational, IT, and vendor teams to drive project success
  • Maintain open and transparent communication with leadership to keep them informed of project progress and challenges
  • Support post-implementation activities and assist in the rollout of additional IT systems as required
What we offer
What we offer
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan
Read More
Arrow Right

Sr Project Manager - Utilization Management

The Sr Project Manager (Sr PM) leads large-scale, complex, enterprise transforma...
Location
Location
United States
Salary
Salary:
105100.00 - 188020.00 USD / Year
healthfirst.org Logo
Healthfirst
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree from an accredited institution
  • Prior experience leading medium to large scale, complex projects within healthcare, health insurance, or other regulated environments
  • Strong executive presence with the ability to influence decisions and drive alignment across senior leaders and diverse stakeholder groups
  • Demonstrated expertise managing projects with significant operational and technology dependencies requiring analytical, communication, and problem-solving skills
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes for the UM department
Job Responsibility
Job Responsibility
  • Lead end-to-end delivery of complex, enterprise-wide (UM transformation) initiatives focused on operational efficiency, program transformation, technology enablement, and performance improvement
  • Drive UM modernization efforts through implementation of AI, automation, and advanced analytics solutions to improve medical necessity determinations, throughput, and decision accuracy
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes for the UM department
  • Manage a high-volume portfolio of projects with significant cross-functional and technology interdependencies, including operations, clinical, medical management, finance, compliance/regulatory, and IT teams
  • Apply project management best practices, tailoring methodologies as appropriate per initiative
  • Establish and manage project governance, including executive steering committees, decision forums, and escalation pathways
  • Proactively identify and manage risks related to cost, scope, regulatory compliance, operational disruption, and change adoption
  • Track, validate, and report on financial and operational benefits, including cost savings, productivity gains, and return on investment
  • Ensure projects comply with healthcare regulations, internal controls, and quality standards.
  • Drive effective change management to support adoption, sustainability, and realization of UM transformation benefits
What we offer
What we offer
  • medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions
  • Fulltime
Read More
Arrow Right

Senior Manager, Stars and Clinical Initiatives

The Senior Manager, Stars and Clinical Initiatives is responsible for developing...
Location
Location
United States , Los Angeles
Salary
Salary:
135136.00 - 216218.00 USD / Year
lacare.org Logo
L.A. Care Health Plan
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree
  • At least 7 years of Medicare Stars experience including experience driving measurable improvement in quality metrics and Star ratings within a health plan
  • At least 5 years of leadership experience with proven ability to motivate and develop team members
  • At least 5 years of leading staff, supervisor/management experience
  • Experience leading and supporting initiatives aimed at transforming care delivery and improving health outcomes for vulnerable populations through a service-oriented, mission-driven approach
  • Experience leading teams, projects, or cross-functional groups
  • Deep knowledge of Stars, Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPs), and related quality improvement programs
  • Strong knowledge of CMS and state regulatory standards and industry trends
  • Excellent analytic skills to conduct analysis and develop recommendations with proficiency in Stars data analysis, performance modeling, and reporting
  • Ability to work across functions and build strong collaboration and partnership with diverse internal and external stakeholders
Job Responsibility
Job Responsibility
  • Lead the development, implementation, and continuous improvement of clinical and quality improvement programs that support D-SNP and Covered California Star performance
  • Collaborate closely and build cross-functional alignment with internal teams to develop and implement evidence-based best practices
  • Serve as Medicare and Covered California Stars subject matter expert and strategic thinker while also being a hands-on, operational and execution-focused leader
  • Analyze data, distill actional insights, and incorporate into program evaluations and data-driven continuous improvement strategies
  • Deliver reports to required committees and workgroups
  • Stay updated on industry trends and best practices including around the application of Artificial Intelligence (AI) tools to improve quality of care, member experience, and member outcomes
  • Support the adoption of new technology and innovation to elevate Stars performance and member outcomes
  • Engage with external stakeholders including vendors, community organizations, and other solution providers to build new partnerships that elevate Stars performance and services for members
  • Identify and manage Centers for Medicare and Medicaid Services (CMS) and state regulatory updates and risks to ensure compliance with standards
  • Execute risk mitigation activities
What we offer
What we offer
  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)
  • Fulltime
Read More
Arrow Right

Associate Vice President, Quality

Join Amgen's Mission of Serving Patients. At Amgen, if you feel like you're part...
Location
Location
United States , Thousand Oaks
Salary
Salary:
266028.00 - 359920.00 USD / Year
amgen.com Logo
Amgen
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Doctorate degree and 7 years of Clinical & Research Quality experience OR Master's degree and 10 years of Clinical Quality experience OR Bachelor's degree and 12 years of Clinical Quality experience AND 7 years of managerial experience directly leading people in a multi-tiered organization and/or leadership experience leading teams, projects, programs or directing the allocation of resources
Job Responsibility
Job Responsibility
  • Ensures proper quality oversight strategies of research activities and RBQM in clinical trials
  • Lead a global team and manage all trials across the Amgen portfolio globally
  • RDQ has a key role and responsibility in driving embedded quality partnerships across critical R&D programs
  • RDQ has a key role in advancing data driven oversight capability across the organization
  • Responsible for inspection readiness, inspection execution and follow up
  • Expanding our capabilities beyond GCP compliance and audit mindset focus include: Biosimilars, Rare Disease, Precision Medicine, Digital technology, Labelling, Product Complaint/Safety Reporting, PASS Study Management, Clinical trial simplification, Data analytics, Metrics development, R&D activities in response to regulatory trends and external pressures, Quality and compliance oversight over Amgen General Medicine: cardiovascular, obesity
  • Oncology, Inflammation and Biosimilar Portfolios
  • RDQ is transforming into an organization that provides quality assurance through proactive quality oversight in clinical trials on quality by design, critical to quality measures and risk-based quality assurance
  • Oversight of FSP and ensures performance of vendors is adequately executed for each study
  • Leads health authority inspection readiness and inspection strategy for clinical globally
What we offer
What we offer
  • Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
  • A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
  • Stock-based long-term incentives
  • Award-winning time-off plans and bi-annual company-wide shutdowns
  • Flexible work models where possible
  • Fulltime
Read More
Arrow Right