Senior Project Manager of Clinical Transformation Job at Healthfirst

Senior Project Manager Utilization Management

The Sr Project Manager (Sr PM) leads large-scale, complex, enterprise transforma...

Location

United States

Salary:

105100.00 - 188020.00 USD / Year

Healthfirst

Expiration Date

Until further notice

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

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

medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions

Fulltime

Senior Manager of Business Intelligence

As a Senior Manager of Business Intelligence for the Quality zone, you will be a...

Location

United States , Bethesda

Salary:

Not provided

Aledade, Inc.

Expiration Date

Until further notice

Requirements

10+ years of experience in business intelligence
3+ years of managerial experience
Deep expertise in healthcare quality measurement, with a strong understanding of frameworks such as NQF, eCQMs, MA STARs, HEDIS, and MIPS
Proven track record of partnering with senior and executive-level stakeholders to translate complex clinical/quality business needs into a strategic, actionable analytics roadmap
Specific experience managing or overseeing MSSP Quality Reporting and MA STARs performance data
Expert-level proficiency in SQL and deep, hands-on experience with a modern data stack, including Snowflake for data warehousing, dbt for data transformation, and Tableau for data visualization
Extensive experience analyzing complex healthcare data (e.g., medical claims, EHR, clinical registries) within a value-based care framework
Exceptional communication and storytelling skills, with the ability to distill complex analytical findings into clear, actionable insights for a wide range of audiences, including executive leadership
Expertise in data warehousing principles and scalable data modeling concepts to build robust, foundational data solutions
Proven ability to lead an analytics team within an agile framework, effectively managing team sprints, backlogs, and project roadmaps

Job Responsibility

Drive Strategic Impact (25%): Act as a key strategic partner to senior leaders within the Quality and Clinical domains. Translate evolving regulatory and clinical needs into a clear technical roadmap, delivering analytics that measure MSSP and MA STARs performance, demonstrate clinical value, and drive patient health outcomes
Develop & Mentor Your Team (25%): Manage, coach, and develop a high-performing team of individual contributors, including leads and senior analysts. Foster a respectful and supportive environment where team members can grow, providing regular feedback, career mentorship, and opportunities for development
Champion Excellence & Collaboration (20%): Lead your team in agile processes, anticipating and mitigating roadblocks. Promote a "one team" mentality through cross-functional partnership, ensuring tight alignment with Payer & Network BI Zones to ensure Data for Good measures (e.g., diabetes care) are integrated into broader company performance views
Own the BI Vision & Roadmap (15%): Take full ownership of the BI roadmap and quarterly planning for the Quality domain. Work closely with key stakeholders on strategy, demand management, and prioritization to ensure the team is delivering the most valuable data products for regulatory reporting and clinical improvement
Deliver Actionable Insights (15%): Oversee the development of interactive dashboards, executive-level reports, and presentations that clearly communicate insights on Quality measurement, gap-closure opportunities, and the efficacy of clinical programs

What we offer

Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options

Fulltime

New

Senior Manager, Stars and Clinical Initiatives

The Senior Manager, Stars and Clinical Initiatives is responsible for developing...

Location

United States , Los Angeles

Salary:

135136.00 - 216218.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

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

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

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Head of Clinical Service, Children and Families

Join a forward-thinking, values-led organisation where you can make a tangible d...

Location

United Kingdom , Nottingham

Salary:

57528.00 - 64750.00 GBP / Year

Nottingham CityCare Partnership CIC

Expiration Date

June 28, 2026

Requirements

Good awareness and understanding of 0 to 19s services and the public health agenda
Knowledge and experience of transformational change management
Experience and demonstrable skills in advanced negotiation, motivational, explanation and reassurance skills across a range of management issues
Project management skills
Knowledge and experience of managing operations at a senior level in Health and Community Services/secondary care
Knowledge and experience of communicating, developing and maintaining partnerships with external agencies, professional leads and staff
Ability to manage individuals and services in a complex and changing environment
Control and management of budgets
Knowledge and experience of high level analytical and innovative problem-solving skills
Health/social care/leadership qualification or equivalent work experience to Masters level within a health or social care field

Job Responsibility

Lead and shape the delivery of integrated children's services, working at pace across organisational boundaries to improve outcomes for children, young people and families
Provide visible, values-based leadership, setting direction, building strong partnerships and creating a culture of high performance, learning and continuous improvement
Drive service transformation, supporting teams through change with clarity, resilience and compassion, and ensuring services remain responsive to local need and national priorities
Influence system-wide working, collaborate with senior stakeholders, and contribute to strategic developments, including the ongoing Best Start tender process
Use strong analytical and problem-solving skills to understand performance, identify risks and opportunities, and implement improvement initiatives
Communicate effectively, engage teams and stakeholders, and maintain a focus on quality, safety and equity
Operationally manage multi-disciplinary teams within Childrens Services
Manage and support staff through transformation
Be responsible for the delivery of seamless, specialist and integrated health and social care services for children, young people, and families
Be responsible for service development and the development of an integrated approach to care

Fulltime

Senior Manager, Patient Safety

The Senior Manager, Medical Device end to end Management is a leadership role re...

Location

India , Hyderabad

Salary:

Not provided

Parexel

Expiration Date

Until further notice

Requirements

Experience in Patient Safety Services
demonstrated success in clinical, medical, or scientific domains
People management capabilities with experience leading teams
Experience in client relationship management
Understanding of pharmacovigilance operations, clinical research methodologies, and regulatory frameworks
Clinical experience with progressive responsibilities
Strong clinical, regulatory, and medical Patient Safety Services knowledge
Good understanding of ICH, CIOMS, GVP, and pharmacovigilance requirements
Familiarity with automation/AI in pharmacovigilance
Adaptable mindset with enthusiasm for learning

Job Responsibility

Lead the complete lifecycle of medical device complaint handling and post-market surveillance
Oversee FDA MDR reporting including 5-Day, 30-Day, and Supplemental Reports
Ensure high-quality investigations, root cause analysis, and CAPA linkage
Maintain compliance with 21 CFR 803, 820, ISO 13485, and internal QMS standards
Partner with Regulatory, Quality, R&D, and Manufacturing teams to manage product performance and patient safety insights
Support FDA inspections and internal/external audits
Manage and mentor a high-performing complaint operations team
Delegate work to Patient Safety staff according to allocated budget/hours
Coordinate with Solutions Consultant and/or regional Head of Safety Services as appropriate to assign resources to the project, and to assess staffing needs for current and future activities
Conduct interviews for recruitment of new personnel as necessary

Fulltime

Interim Project Manager

Are you a Band 8a Project Manager looking for your next NHS contract role? We ha...

Location

United Kingdom , Croydon

Salary:

33.00 - 35.00 GBP / Hour

Hunter Gatherer AHP

Expiration Date

Until further notice

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

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

Fast & simple registration process
Reliable, weekly payroll
Specialist NHS recruitment consultants
Exclusive NHS contract opportunities
Long-term contract opportunities
Industry insights & market support

Fulltime

Senior Manager, Inspection Management

Location

United States , Cambridge

Salary:

130800.00 - 209400.00 USD / Year

Moderna

Expiration Date

Until further notice

Requirements

BS/BA, MS or PhD and a minimum of 10, 8, 6 years’ experience, respectively, in Biotech, Pharma or Clinical Research Organization.
Knowledge of relevant FDA, EU, ICH GCP guidelines, and applicable international GxP regulations, guidelines and local legislation.
Knowledge of relevant FDA, EU, guidance for computerized systems is a plus.
Experience with inspection coordination and logistical planning for regulatory authority inspections.
Experience with work in the Regulatory Intelligence area.
Experience developing responses to regulatory authority inspection findings.
Experience working with CROs, vendors, and relationship management.
Leadership skills with ability to effectively organize and execute tasks
Ability to interact effectively with all levels within the organization.
Ability to work both independently and in a team environment.

Job Responsibility

Build and maintain strong and productive relationships with key stakeholders within R&D to support the successful and compliant execution of Moderna regulatory inspection activities.
Maintain in-depth knowledge of governmental regulations affecting GCP, GVP, GLP in the drug development process.
Plan, and coordinate GCP, GVP, GLP, GCLP regulatory authority inspections (routine, directed or submission driven) and the pre-inspection request process.
Coordinate and manage inspection readiness and preparation activities such as inspection management trainings, mock inspection interviews, mock inspections, site risk assessments and clinical site inspection preparation visits in preparation for regulatory authority inspections.
Provide guidance and direction in development of responses to observations resulting from inspections of Moderna’s R&D programs.
Ensure any critical and major inspection findings have appropriate Corrective and Preventative Actions (CAPA) and are tracked to completion and verification of effectiveness.
Lead and manage post-inspection lesson’s learned sessions, ensuring all actions are tracked to completion.
Contribute to and maintain inspection management plans, trainings, and strategies for the R&D Quality inspection management program.
Review and provide input into study team inspection preparation activities, storyboards, etc.
Collaborate with industry through benchmarking of regulatory activities that may influence regulatory inspection activities and strategies.

What we offer

Best-in-class healthcare coverage, plus voluntary benefit programs to support your unique needs
A holistic approach to well-being, with access to fitness, mindfulness, and mental health support
Family planning benefits, including fertility, adoption, and surrogacy support
Generous paid time off, including vacation, volunteer days, sabbatical, global recharge days, and a discretionary year-end shutdown
Savings and investment opportunities to help you plan for the future
Location-specific perks and extras

Fulltime

Project Manager

We are looking for an experienced Project Manager to join our team in Geneva, Il...

Location

United States , Geneva

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

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

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

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

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Senior Project Manager of Clinical Transformation

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