Clinical Program Manager Resume Samples

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J Mante

Jermain

Mante

738 Margie Valleys

Dallas

+1 (555) 596 9189

738 Margie Valleys

Dallas

Phone

p +1 (555) 596 9189

Experience Experience

San Francisco, CA

Clinical Program Manager

San Francisco, CA

Price, Bechtelar and Lehner

San Francisco, CA

Clinical Program Manager

Work collaboratively with the BCVI outcomes management program and operational managers to systematize the monitoring and management of BCVI programs
Reviews work performed by other and provides recommendations for improvement
Participates in quality management activities including identifying and communicating issues of performance improvement and risk in a timely manner
Provides professional program management for 2 or more complex development programs
Report program performance against expectation and influence changes to programs to improve competitive position and optimize performance
Revenue Generation - Works jointly with Account Manager to ensure revenue goals, administrative expenses are managed
Facilitates the development of clinical reports and the delivery of data to key provider partners; as well as develops internal reports to demonstrate progress

Phoenix, AZ

Stars Clinical Program Manager

Phoenix, AZ

Aufderhar Inc

Phoenix, AZ

Stars Clinical Program Manager

Direct analysis to continuously assess and define how members are coming into the denominator (timing and source of data) for 2 Stars HEDIS Musculoskeletal Condition measures; OMW and ART
Profile the ART and OMW denominator and develop specialized initiatives for each unique subgroup; test and prove new/ different tactics
Understand and map connections for compliance opportunity across other Humana clinical processes
Manage and develop team analyst
Direct and oversee development of trend reports and comprehensive performance dashboard
Manage and oversee call team resources necessary to execute the end to end process while also continuously reevaluating existing work processes in order to predict, address and resolve efficiency and accuracy constraints
Define and continuously refine market collaboration efforts for OMW and ART; create and maintain an OMW and ART Market Playbook

present

Philadelphia, PA

Senior Clinical Program Manager

Philadelphia, PA

Walker and Sons

present

Philadelphia, PA

Senior Clinical Program Manager

present

Provide project management support for a variety of highly complex palliative care programs across OptumCare
Manages a variety of local and regional projects to drive palliative care implementation and program performance
Works both remotely and on-site with clinical and business leaders
Communicates/reports project status and program performance up and down the chain to maintain standardized reporting structure
Act as coordinator for both internal and external resources, and be responsible for leading the overall project execution
Works closely with OptumCare leaders and front line staff to implement and expand palliative care programs, drive operational performance and address barriers to growth
Works closely with LCDO and CPM analytics teams as well as Optum Health Care Economics team to support program performance measurement and improvement

Education Education

Bachelor’s Degree in Nursing With Current Licensure

Johnson & Wales University

Bachelor’s Degree in Nursing With Current Licensure

Skills Skills

Strong communication and influencing skills and ability to create a clear sense of direction is necessary
Knowledge: Applies mastery of in-depth knowledge in one job family or broader expertise in most areas of a job function
Knowledge of, and experience applying Good Clinical Practice (GCP) and ICH Guidelines
Strong work ethic and demonstrated ability to deliver assignments on time
Strong communication and influence skills and ability to create a clear sense of direction is necessary
Demonstrated ability to organize and present scientific information (e.g., clinical study results) to internal and external audiences
Ability to participate in and/or lead departmental or interdepartmental strategic initiatives under limited supervision
Ability to examine functional issues from a broader organizational perspective
1-3 years’ experience as a CRA including the ability to interact effectively with investigators and cross-functional teams
Working knowledge of FDA Device guidelines and regulations

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Clinical Program Manager Resume Examples & Samples

College degree or higher, preferentially in sciences/medical sciences
5 years CPM experience with RESPIRATORY
GLOBAL CPM experience
Previous experience overseeing CRO’s
Strong communication and organizational skills—understands team environment
Strong management and motivation skills
Ability to manage study teams and perform issue escalation
Flexible and able to work with deadlines
Team player who can also operate alone
Solution-oriented and problem solving attitude
Vendor/CRO and budget management skills
Knowledge of trial budget management and patient fees

Clinical Program Manager Resume Examples & Samples

Bachelor’s degree or higher in a scientific discipline
8+ years of Clinical Program Management experience within a pharmaceutical or clinical research environment; global trial experience required
Strong vendor management experience
Experience in CNS disease and/or orphan indications ideal

Senior Clinical Program Manager Resume Examples & Samples

Provide project management support for a variety of highly complex palliative care programs across OptumCare
Manages a variety of local and regional projects to drive palliative care implementation and program performance
Works both remotely and on-site with clinical and business leaders
Works closely with the Chief Clinical Officer to coordinate project deliverables and activities with clinical training requirements
Communicates/reports project status and program performance up and down the chain to maintain standardized reporting structure
Act as coordinator for both internal and external resources, and be responsible for leading the overall project execution
Works closely with OptumCare leaders and front line staff to implement and expand palliative care programs, drive operational performance and address barriers to growth
Works closely with LCDO and CPM analytics teams as well as Optum Health Care Economics team to support program performance measurement and improvement
Strives to create a culture of collaboration and standardization across the enterprise
Monitor and document project milestones and outcomes throughout the project lifecycle to ensure adherence to established quality standards
Maintain PMO tools for analysis and reporting for the initiatives
Track and escalate issues and risks, ensuring full mitigation and resolution, drive the project holistically and work on a variety of projects across the organization
Drive/participate in the capital request process, as appropriate (e.g., presentations, cost-benefit analysis, business case)
Responsible for identification and recommendation of possible opportunities to generate new medical affordability opportunities based on program experience and internal data
Accountable for financial management through the lifecycle of project and managing budget expectations around savings and revenue projections
Work closely with innovation and technology teams to deliver palliative care enabling capabilities and solutions to improve palliative care performance such as Telehealth, Voice Recognition Software, EMR systems, identification and stratification tools, and mobile applications
Routinely participates and may present in strategic leadership meetings
5+ years of clinical program manager experience in a healthcare setting
Demonstrated exceptional oral and written ability to communicate with internal and external stakeholder leadership
Experience working with, and leading, remote teams
Ability to learn new concepts and business models very quickly
Ability to think and perform at a high level in a highly changing business environment
Demonstrated experience in leading a high performing project teams and collaborating with stakeholders at all levels of an organization
Proficiency with MS Excel and PowerPoint
Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
Ability to travel (approx. 25%)
Registered Nurse experience
Experience working with advanced illness programs or palliative care services
3+ years of Managed Care experience
Proficiency with MS Project, Visio and SharePoint
8+ years of combined technical/business and project management experience
PMP certification (or equivalent), Six Sigma or LEAN certification

Pediatric Clinical Program Manager Resume Examples & Samples

Develop and provide oversight of pediatric programs, with a focus on special needs and management of medically fragile pediatric members
Development and maintenance of applicable P&P to support pediatric programs
Provide necessary training and coaching of service coordinators assigned to pediatric members that includes comprehensive assessments and development of individualized service plans that meet the compliance and quality standards
Work collaboratively with service coordinator managers in the coaching and shadowing of service coordination staff as necessary
Conduct chart audits of pediatric members to ensure standards are met
Conduct member home visits with service coordinator as necessary
Manage and support care transitions (discharges) of complex pediatric members to ensure all necessary equipment, transportation, training of primary care givers, etc. to ensure safe discharge
Single point of contact for Kapiolani Medical Center case managers
Building relationships with internal and external customers including physicians, home health agencies, healthcare facilities and durable medical equipment suppliers
Developing program initiatives; creating policies and procedures
Ensuring state and federal compliance
Educating the community of providers about our program
Influences or provides input to forecasting and planning activities
RN Licensure in the state of HI
3+ years Pediatric experience
3+ years of managerial experience in a healthcare setting
Electronic documentation experience
Intermediate / Advanced level experience of Microsoft office software programs
MSN and NP Clinical licensure and work experience
Prior experience working with community organizations in Hawaii ie: Womens and Children's Hospital
Experience developing and presenting educational programs for professionals and lay persons
Experience in a corporate environment
Medicaid knowledge
Utilization management experience
Bilingual Asian language skills such as Filipino, Chinese, Samoan, Korean, Vietnamese or Japanese

Pediatric Clinical Program Manager Resume Examples & Samples

Current, unrestricted, RN Licensure in the state of HI
3+ years of Clinical RN experience
BSN, MSN or NP Clinical licensure and work experience
3+ years of Pediatric experience

Transplant Clinical Program Manager Resume Examples & Samples

5Ensures that staff are well informed by communicating new/revised protocols, policies and procedures, guidelines and standards to staff in a timely manner
6Ensures that staff members maintain competency based on identified standards of practice for patient population
7Engages staff in the development and implementation of departmental and system goals and bjectives/strategic plan
8Provides patient care as needed for age-specific patient population
4Champions service excellence initiatives and ensures consistent implementation and continued use by staff
5Cultivates an environment that is supportive of staff’s professional and personal growth. Plans, develops implements and evaluates departmental succession plan
6Ensures the provision of a comprehensive onboarding/orientation program for newly-hired staff
7Assesses new staff with regard to transplant core competencies in order to ensure patient safety
2Leads and participates in departmental, hospital and system-wide programs, committees, and special projects to achieve desired outcomes
3Collaborates with medical, allied health and administrative staff to ensure the provision of safe, quality, compassionate health care
3Recognizes, responds and provides follow-up to issues, concerns and suggestions on behalf of the patient population, members of the multidisciplinary team and referring physicians
4Provides timely follow-up on critical incidents and sentinel events and provides leadership in system redesign to promote a culture of safety for patients, families and staff
5Analyzes and prioritizes competing demands, taking effective action to redesign systems to best meet the needs of patient population and staff
6Actively participates in the investigation, selection, piloting, implementation and evaluation of information and communication technology
7Implements human resource management processes (recruiting, hiring, evaluating/coaching for improved performance and professional development, and terminating employees) to provide qualified, cost-effective staffing
8Interprets and guides nursing and department based staff on BHCS policies and procedures
9Assumes accountability, responsibility and authority for daily clinical operations at department level
3Demonstrates commitment to community service, especially with regard to organ donor awareness
2Prepares for, facilitates and oversees transplant specific regulatory audits/ surveys
3Prepares and submits required data for transplant managed care Requests for Information (RFIs)

Senior Clinical Program Manager Resume Examples & Samples

Displays highly developed project leadership qualities
Deep understanding of Clinical Operations and Drug Development. Expert on assigned protocols
Demonstrates ability to integrate and summarize medical/scientific concepts in protocols and other documents
Proactively seeks out and recommends process improvements
Proven track record of anticipating potential study issues and preparing contingency plans with minimal oversight
Communicates clearly and effectively with internal and external key stakeholders
Routinely mentors and may supervise junior staff. Takes a leadership role in on boarding new personnel
May contribute to Clinical Development Plans with some oversight
Consistently demonstrates overall leadership in Clinical Operations
Develops and oversees study operational plan(s)
Coordinates internal and external clinical development activities of all team members involved in the design and conduct of assigned clinical trials
Assists with protocol design and strategy and medical issue resolution,
Participates in study data review and assists with patient narrative writing and other data review activities as assigned
Contributes significantly to relevant study documentation including clinical protocols, statistical analysis plan, and clinical study reports
Proactively identifies project risks and resolves
Represents Clinical Operations in cross-functional initiatives, as assigned by management, and may act on behalf of team
Able to develop and execute complex study plans in one or more clinical studies with minimal supervision
Develops study budget(s)
Attends scientific meetings and builds relationships with Investigators, business partners
Participates in and contributes to publication strategy and content
Assumes a lead role in the identification process of Investigators or vendors and assures proper prequalification of clinical sites
Ensures external and internal documentation prepared within the Clinical Operations function is completed in accordance with GCP regulatory requirements and consistent with the protocol, for all assigned programs/trials
May represent Clinical Operations on Clinical Development Team(s)
Manages team and individual performance appropriately
May supervise other clinical staff
B.S. or Advanced Degree in a scientific or allied health field (or equivalent degree/experience in the opinion of the Hiring Manager) and 7 years of relevant work experience in the Biotech or Pharmaceutical Industry or relevant comparable background

Associate Director, Clinical Program Manager Resume Examples & Samples

Identify, recruit, hire, and develop Clinical Operations team members as well as oversee their work for assigned projects to ensure all department goals, deliverables, and objectives are met
Manage direct reports including development, coaching, mentoring, performance management, and succession planning
Ensure that employees are appropriately trained and comply with company and regulatory standards
Create a positive work environment by encouraging mutual respect, innovation, and accountability
Resource projects to enable teams to meet deliverables
Create and maintain Clinical Operations team and Avid as a great place to work
Participate in and/or lead working groups and/or initiatives within clinical operations or cross-functionally as needed
Optimize and continually improve processes
Create an environment supporting innovation and smart risk to help the department continuously evolve, improve, and excel
10+ years’ experience of clinical and drug development, including 5+ years of clinical trial management experience 2+ years of clinical program management experience
Master’s degree in scientific or healthcare discipline preferred
Working knowledge of international regulatory and ICH GCP guidelines
Functional management experience
Demonstrated understanding, knowledge, and experience of drug development in a complex setting
Strong analytical and strategic agility skills
Exceptional leadership skills, including motivation and delegation
Highly effective team player and exceptional interpersonal skills
Strong financial acumen with experience managing clinical program budgets
Ability to provide functional management including performance coaching and staff development
Ability to implement and manage a clinical program (i.e. a series compromising a clinical development plan)
Ability to drive, encourage and support innovation
Demonstrated ability to challenge established practices and concepts
Highly effective verbal and written communication skills in English

Senior Clinical Program Manager Resume Examples & Samples

Must meet all requirements for CPM position and have demonstrated proficiency in all relevant areas
Provides leadership, late phase subject matter and therapeutic expertise for the successful management of late phase international and country specific clinical trials
Contributes to the strategic implementation of a clinical development program(s)
Demonstrated ability to manage international clinical trials within designated program budgets and timelines is required
Must possess a proven ability to effectively communicate scientific, medical, and organizational concepts to internal and external customers
Extensive experience in developing RFPs, selection of CROs/vendors and management of external resources is required
Ability to initiate, participate in and/or lead departmental or interdepartmental strategic initiatives
Participates in development of SOPs, Clinical Study Reports, INDs, NDAs and other clinical, regulatory and safety documents
Provides input into the management of the Clinical Operations department - Effectively solves problems and uses judgment relating to national and international regulations, guidelines, investigator interactions and timelines
Excellent interpersonal skills, ability to lead multifunctional teams, ability to manage staff and mentor junior staff is required
Recruits, hires, mentors and manages Sr. CTMA/CTM/Sr. CTM/CPM direct reports and supports their professional development
Travels nationally and internationally as required
Knowledge of FDA and/or EMA Regulations (or relevant local regulations), ICH Guidelines, and GCP governing the conduct of clinical trials and non-interventional studies
At least 8+ years of experience and a BS or BA in a relevant scientific discipline
At least 8+ years of experience and an RN (2 or 3 year certificate)

Clinical Program Manager Resume Examples & Samples

To serve as the local Clinical Operations representative and point of contact for Clinical Operations Asia Pacific, US study teams and investigators under management of CPM Asia Pacific
To partner with US study team and CRO to maintain cross functional study timelines and troubleshoot country/site specific operations issues
To leverage local knowledge and relationships and to work collaboratively with Gilead affiliate personnel (Medical Affairs, Regulatory, Drug Safety and Public Health) to ensure optimal support for Gilead’s clinical development programs and to ensure relevant information from sites is triaged and communicated to the study teams and TA Leads as necessary
To provide a local perspective and input into clinical development planning, document generation/review and regulatory filing as required
To manage local/regional PIV Gilead Sponsored trials as required
To provide operational support to Medical Affairs in the oversight of local/regional Investigator Sponsored Trials (ISTs)
Must meet all requirements for Clinical Trial Manager position and have demonstrated proficiency in all relevant areas
Provides local operational perspective and advice and supports the oversight of international development clinical trials conducted in country/region. This may include assisting with protocol review and study planning, coordination of feasibility and site list validation in collaboration with Medical Affairs, acting as local sponsor contact for investigators and CROs, conducting accompanied monitoring visits, assisting with investigator meeting arrangements and assisting with the resolution of specific operational issues through effective collaboration with Medical Affairs as directed by Clinical Operations Asia Pacific and/or US study teams
Manages local/regional Gilead sponsored trials as required and supports Medical Affairs in oversight of ISTs within designated program budgets and timelines
Maintain operational knowledge of progress and conduct of all studies involving investigators in country/region (Clinical Operations Asia Pacific and US managed)
Develop knowledge of and good working relationships with investigators involved in clinical research within the country/region
Partners with functional peers to manage, adjust, and revise project timelines/budgets as necessary. Develops RFPs, contributes to vendor selection, and manages external resources
Ensure local consistency and alignment with GSI global processes and procedures
Participates in development of SOPs, Clinical Study Reports, INDs, NDAs, and other clinical, regulatory, safety documents as necessary
Contributes to development of abstracts, presentations, and manuscripts as necessary
Oversees and operationally supports assigned staff performing the role of line manager as required. This might include recruiting, hiring, mentoring, training and managing CPA/CTMA direct reports and supporting their professional development as necessary
May determine activities critical to company success and priorities within functional area. Anticipates moderately complex obstacles and client difficulties and implements solutions to achieve project goals
May design and use all available vehicles for scientific communication within company
Participates in and contributes to regular Clinical Operations Asia Pacific meetings to facilitate information exchange and ensure alignment
Maintains up to date knowledge of local, regional and global clinical trial legislation
Serves as an ambassador for Gilead Sciences International and Global Clinical Operations, both internal & external
Supports Clinical Operations Asia Pacific Associate Director or Director in departmental and process improvement initiatives as required
National, regional and international travel may be required (about 20-25%)
Typically requires a BSc in a relevant scientific discipline (or equivalent nursing qualification). A MSc or PhD would be advantageous
Must have at least 8 years of experience in pharmaceutical industry, preferably in both pharmaceuticals and CROs, with demonstrable expertise in clinical operations and drug development
Must have at least 4 years of experience in leading country clinical trials activities, regional project management and/or people management
Excellent interpersonal skills, and demonstrate ability to lead is required
Proactive in troubleshooting problems using national and international regulations, guidelines, and by mobilizing relationships with internal/external stakeholders
Strong communication and influencing skills and ability to create a clear sense of direction is necessary
Experience in managing staff as well as mentoring and developing junior staff is desirable
Thorough knowledge and understanding of FDA and EMA Regulations, ICH Guidelines, and local GCPs governing the conduct of clinical trials is required
Must have a demonstrated ability to successfully develop, implement, manage and complete clinical trials
Experience in developing RFPs and selection and management of CROs/vendors
Ability to write study protocols, study reports, sections for investigator brochures, and regulatory documents (e.g. IND, DNA, etc.) with little supervision
Ability to participate in and/or lead departmental or interdepartmental strategic initiatives under limited supervision
Functional expertise to initiate, author, or contribute to SOP development, implementation, and training
Fluency in English and Chinese, both oral and written communications
Must be able to travel, nationally, regionally and internationally as required (about 20-25%)

Clinical Program Manager Resume Examples & Samples

Oversees successful implementation of Gilead (GS), Collaborative (CO), Investigator Sponsored Research (ISR) program, expanded access programs, and compassionate use programs
For GS studies, ability to write study protocols, study reports, and regulatory documents (e.g. IND, NDA, PRAC etc.) with little supervision
Contributes to development of abstracts, presentations, and manuscripts
For GS, CO, and ISR studies, must have a demonstrated ability to successfully develop, implement, manage and complete clinical trials
Provides guidance and oversight for the successful management of all aspects of international clinical trials within designated program budgets and timelines
May represent the company at professional events
May represent the department at cross-departmental events
Recruits, hires, mentors and manages CPA/CTMA/Sr. CTMA/CTM/Sr. CTM direct reports and supports their professional development
Anticipates moderately complex obstacles and client difficulties and implements solutions to achieve project goals
Excellent interpersonal skills and demonstrated ability to lead is required
Thorough knowledge and understanding of FDA and/or EMA Regulations (or relevant local regulations), ICH Guidelines, and GCPs governing the conduct of clinical trials and non-interventional studies

Clinical Program Manager Resume Examples & Samples

Plan and manage the overall execution of the assigned clinical program to meet necessary quality, budget and timelines, including making or recommending operational strategies and/or decisions (with input from Associate Directors, Clinical Operations and Regions) in support of achieving clinical program objectives; Responsible for Early Engagement process with Strategic Partners
Represent Clinical Operations globally as a member of the Global Development Team, working closely with GDT Leadership to ensure program objectives are met; May represent Clinical Operations for assigned program in issue escalation/awareness with senior management, e.g. regional executive staff, GMC, alliance governance committees
Responsible for program budget planning and accountable for external spend related to program execution. Works closely with Clinical Study Manager(s), Project Management, and Finance to ensure on a regular basis that budgets, enrollment, and gaiting are accurate; Communicates program status, cost and issues to ensure timely decision-making by senior management
Oversight of Strategic Partners/CRO/vendor selection, budget and contract negotiation, and proper supervision of performance for all activities assigned to a Strategic Partner/CRO/vendor for assigned program, including escalation of issues to governance committees when warranted; Responsible for operational risk management strategy in collaboration with Strategic Partners
Review and provide expert clinical operations input into clinical documents related to the drug development process including Investigator Brochures, Investigational New Drug Applications (INDs) and/or Investigational Medicinal Product Dossier (IMPDs), study synopsis protocols, clinical study reports, applicable sections of the New Drug Application (NDA) and/or Marketing Authorization Application (MAA), and updates to IND and NDA documents; Provide expert clinical operations input into preparation for key regulatory meetings (e.g. End-of-Phase 2 and 3 Meetings, Request for Scientific Advice Meetings, etc.), as appropriate
Responsible for the operational due diligence for new compounds/alliances for budgeting, timelines, and enrollment modeling, in collaboration with Director, Clinical Operations
May be asked to represent Takeda at internal and external meetings, including Investigator Meetings
Experience: 8+ years experience in pharmaceutical industry and/or clinical research organization, including 5+ years clinical study management. Experience must include Phase 2 and 3 studies and global/international studies or programs. Experience in more than one therapeutic area is required

Clinical Program Manager CA Rancho Cordova Resume Examples & Samples

Serves as project leader for cross functional initiatives that are intended to drive performance improvement engaging across functional teams as needed to ensure effective communication of project requirements, as well as tracks progress of action plans
Facilitates the development of clinical reports and the delivery of data to key provider partners; as well as develops internal reports to demonstrate progress
Performs detailed analysis of data, workflows, policies, procedures and organization of staff, in order to execute initiatives
Experience making presentations in group settings
At least two years management experience

Clinical Program Manager Resume Examples & Samples

Plan clinical projects
Develop and review project descriptions, project budgets and associated contracts (e.g., funding, CROs, etc.) to assure compliance with policies
Develop and/or oversee development of other project-related documents including protocols, case report forms, study manuals, informed consent forms, monitoring plans, communication plans, tracking tools, and other project tools as needed
Evaluate and select CROs, contractors and other outside vendors
Anticipate areas of risk, and plan and implement solutions to mitigate these risks
Assure good communication among the project team which is made up of members from within the organization and outside vendors/collaborators
Track and report on progress of clinical projects to the extended project team and management as appropriate
Reconcile budgets and authorize payments
Proactively identify problem issues and facilitate discussion of potential solutions that can be implemented by the project team
Maintain strong relationships with key stakeholders and partners in collaborative efforts (universities, government agencies, not-for-profit organizations, pharma/biotech companies)
Have a Bachelors or Master’s degree in life sciences, healthcare, project management/business, or related field
Have at least 5 years of pharmaceutical industry/biotech/CRO/academic experience in clinical research project/trial management including budgeting, contracting and study execution
Be a proactive, creative problem solver and open to innovative solutions
Be detail-oriented and care about the quality of her or his work
Have demonstrated the ability to work independently in a distributed, interdisciplinary, team-oriented environment
Be proficient in the following Microsoft applications: Excel, PowerPoint, and Word
Be comfortable in a fast-paced, dynamic environment
Knowledge of, and experience applying Good Clinical Practice (GCP) and ICH Guidelines
Advanced skills using Excel to develop tracking and budget/invoicing spreadsheets; proficiency in MS Project
Experience working on CNS clinical research or drug development
Experience with regulatory agencies
Experience negotiating vendor agreements

Clinical Program Manager Resume Examples & Samples

Research data for identification of clinical content (CPT, ICD-10-CM, ICD-10-PCS, & other code sets) opportunities or required maintenance gathered from coding and billing guidelines, clinical literature, healthcare industry guidelines
Work closely with the Analytics team to either identify new opportunity or validate/confirm development of data analysis
Create and maintain Clinical User Documentation (internal and external product users) and content reports on quarterly basis
Prepare and deliver product and content training sessions on a quarterly basis to both internal and external customers, as needed
Serve as a clinical resource for stakeholders, internal and external customers to support product content
Work with prospective and existing clients to design population health and care coordination programs
Assist in training and implementation of PRM Analytics tools at client sites
Clinical license (RN, LPN, NP, PA, etc.) required
3-5 years experience as a Case Manager, Care Manager, Care Coordinator, or similar role in a post-acute setting required
Advanced degree in population health administration, public health administration, business administration, epidemiology, or clinical informatics preferred
Demonstrated ability to communicate in both verbal and written communication
Demonstrated analytical skills
Basic understanding of information technology and business concepts
Problem solving and strong communication skills

M.h Clinical Program Manager Resume Examples & Samples

Performs the full range of administrative supervision to plan, assign, oversee, and evaluate the work of subordinate staff and provides technical guidance and support to staff within scope of practice
Participates in the development, negotiation, implementation, and management of the budget for the clinic or programs overseen; ensures that budget and contract allocations reflect program priorities; and takes corrective action where necessary
Formulates policies and procedures with respect to program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum recovery costs for directly-billable services
Develops and monitors revenue-generation procedures and objective for programs managed, including achievement of revenue goals
Develops and implements reporting procedures to ensure that program services utilization and revenue data are reported to accurately and in a timely manner
Coordinates the delivery of staff training necessary to maintain mandated levels of services
Monitors services delivery to ensure that services conform to acceptable standards of care and establishes and modifies program monitoring and review methods as necessary
Oversees audits and the implementation of audit recommendations for programs managed
Represents managed programs in meetings with representatives of other County departments, State and Federal agencies, and other public and private entities
In conjunction with the Patients' Rights Division, investigates complaints from patients and others about programs and services under managerial oversight
Works in a collaborative and timely manner with departmental human resources representatives in matters such as employee investigations and performance, requesting new positions, and reorganizing and relocating staff
Initiates and approves requisitions for supplies and personnel required to operate programs administered
Assists in the negotiation, implementation, and evaluation of departmental program contracts within the jurisdictions served by the programs as needed
In order to qualify, a photocopy of the required license must be attached to your application at the time of filing or within 15 calendar days from the date of application filing. Applications submitted without the required evidence of licensure will be considered incomplete until such information is provided. The original license must be presented during the selection process and prior to appointment

Clinical Program Manager Resume Examples & Samples

Manages the delivery &/or program planning/evaluation of timely, cost-effective & high quality srvs/programs for assigned site(s)
Assures continuity of care & appropriate utilization of resources both w/in & outside of Behavioral Health Care
Assists physicians in short & long-range planning of psychotherapeutic/psychiatric social work programs/srvs that meet identified needs of members & purchasers
Manages psychotherapeutic programs for Addition Medicine &/or psychiatric patients that add value & are integrated w/Behavioral Health Care srv priorities & performance standards, as well as strategic organizational goals/objectives
Integrates & coordinates psychiatry & addiction medicine programs w/other in-& out-patient Depts, as well as w/community resources
Achieves a continuum of care w/in Behavioral Health Care; maintains liaison w/other Psychiatry & Addition Medicine Depts, as well as w/non-Behavioral Health Care Depts
Develops systems & methodologies for continuous improvement of group &/or individual treatment modalities
Evaluates effectiveness of programs & srvs
Reviews/evaluates group therapy designs
Establishes group & testing treatment protocols
May manage programs for specifically defined patient populations such as patients w/life threatening illnesses, dual diagnoses, depression & obsessive-compulsive disorders, trauma related disorders, eating disorders, child psychopathology, & abnormal behavior & personality patterns
Conducts on-going program evaluation of individual &/or group modalities &, in concert w/the Chief(s) of Srv
Develops/maintains systems & processes for outcomes Mgmt/improvement & for identifying the need for revised &/or new clinical treatment programs, designs, protocols
Ensures that the professional practice standards for group &/or individual therapeutic modalities & psychodiagnostic testing are maintained by clinicians
As appropriate, evaluates the professional clinical practice of staff & may provide professional staff w/regular/appropriate training, direction & consultation
May develop & implement policies, procedures & systems to ensure customer/member/patient/purchaser satisfaction & member access
In concert w/other personnel & physicians, responds to & resolves srv, access & provider concerns/issues
Develops & maintains departmental policies & procedures to meet Behavioral Health Care & organizational operational, business & strategic goals/objectives
May participate in-or independently conduct-performance evaluation of professional staff
May hire, train/orient, coach, discipline or terminate professional staff
In concert w/the Chief, maximizes & manages physical, fiscal & human resources
Manages/reduces associated costs
Evaluates/improves utilization & productivity of staff
Less than 50% of working time, may provide direct psychotherapeutic srvs to individual patients &/or patient groups
Minimum two (2) years of experience in managing/supervising the development, delivery and evaluation of clinical mental health programs, including outcomes measurement, evaluation and management; clinical/applied research designs and statistical analyses

Clinical Program Manager Resume Examples & Samples

Bachelor's degree in Business, Marketing, Finance/Accounting, Health Administration, Social Work or Registered Nurse
Healthcare experience, especially with Medicare and Medicaid Clinical Programs
Experience managing and facilitating with the ability to influence without having authority
Act as a thought leader with strong verbal and written communication skills (ability to interact effectively with people at all levels within a team or internal division)
Strong critical thinking, problem solving skills; detailed and well organized
Demonstrates accuracy and thoroughness, identifies process improvements; fosters quality in others
Accepts responsibility, is self-motivated and accountable for achieving implementation and market satisfaction goals
Works within deadlines, demonstrates independence, resourcefulness and self-management skills
Ability to read, analyze and interpret data reports, general business periodicals, professional journals, covering technical and complex compliance procedures and governmental regulations
Proficient with MS Excel, PowerPoint, Access, Visio and MS Project
Previous experience working in a Medicare/Medicaid environment
Knowledge of Humana’s internal policies, procedures and systems

Clinical Program Manager Resume Examples & Samples

Be the Primary MDS Program Clinical Ops Leader – This is a new program for Roxadustat and has high priority/visibility within the Company
Drive current study enrollment and study conduct/process improvement to database closure
Recruit and manage clinical staff and build the clinical operations team in H1 2016 as required
Manage CROs and other vendors such as IWRS, EDC, and central labs
Work with Medical Monitor on clinical trial conduct and oversight

Senior Clinical Program Manager Resume Examples & Samples

Manage a portfolio of 5-7 primary care physician practices, meeting with them on a weekly basis
Install processes to improve member care, population health and affordability of care
Train physician practices in regards to member contact
Strong oral presentation skills, excellent verbal and written communication
Comfortable presenting to peers and leadership
Ability to have a home office
Must have advanced knowledge in excel that includes pivot tables, V-lookups, advanced formulas, graphing/charting and presentations styles
Experience working with databases, Access or large Excel spreadsheets
Experience working for health insurer
Experience in Healthcare Quality
Masters in Informatics

Stars Clinical Program Manager Resume Examples & Samples

Direct analysis to continuously assess and define how members are coming into the denominator (timing and source of data) for 2 Stars HEDIS Musculoskeletal Condition measures; OMW and ART
Profile the ART and OMW denominator and develop specialized initiatives for each unique subgroup; test and prove new/ different tactics
Understand and map connections for compliance opportunity across other Humana clinical processes
Manage and develop team analyst
Direct and oversee development of trend reports and comprehensive performance dashboard
Manage and oversee call team resources necessary to execute the end to end process while also continuously reevaluating existing work processes in order to predict, address and resolve efficiency and accuracy constraints
Define and continuously refine market collaboration efforts for OMW and ART; create and maintain an OMW and ART Market Playbook

Clinical Program Manager, BHC Resume Examples & Samples

Ensures that the professional practice standards for group and/or individual therapeutic modalities and psychodiagnostic testing are maintained by clinicians
Integrates and coordinates psychiatric and/or addiction medicine programs with other in-and out-patient departments as well as with community resources
Achieves a continuum of care within Behavioral Health Care Services
Develops systems and methodologies for continuous improvement of group and/or individual treatment modalities
Delineates inclusion/exclusion criteria and utilizes pre-and post testing evaluations
Minimum three (3) years of clinical experience as a staff clinician in a mental health setting
Minimum one (1) year of experience in managing/supervising the development, delivery and evaluation of clinical mental health programs

Stars Clinical Program Manager Resume Examples & Samples

Collaborate with Humana clinical service areas to learn and understand the in-patient discharge and emergency department release processes and goals
Develop and maintain process maps to create holistic view of how members become denominator eligible and what both the Humana and provider experience looks like when a patient is discharged from an in- patient hospital stay
Define how Stars measure rates should be integrated into hospital admission dashboards currently used across the organization
Serve as measure SME to develop education plan for Stars measures; PCR, MRP and HPC
Act strategically to map and monitor internal processes for Stars gap closure in order to understand opportunities to influence stakeholders to optimize processes based on current state performance
Act strategically to design new solutions utilizing multiple stakeholders across the enterprise. Test new initiatives/ processes in effort to drive rate improvement, ultimately providing better quality of care for our members
Responsible for rate monitoring by Region/Contract to identify where things are going well and why, versus where things need to improve and how
Advanced experience leading special projects and producing metrics, measurements and trend reports
Demonstrated ability to run large scale, highly visible programs with responsibility for multiple project teams
Strong background partnering and influencing other business areas to meet strategic objectives
Process improvement experience
Proficiency in Microsoft Office applications including Word, PowerPoint and Excel
Case management experience
MBA or other Advanced Degree
Six Sigma and/or PMP certification
Demonstrated experience with process documentation and re-engineering

Clinical Program Manager Resume Examples & Samples

Ensure successful management of vendors; work efficiently with study teams, outsourcing and other functions to ensure consistency and quality in vendor processes and execution across studies within the program
Establish, ensure and foster effective communication channels across relevant internal and external stakeholders
Develop in-depth understanding of assigned therapeutic areas and facilitate transfer of knowledge to ensure operational excellence across program
Supervise clinical operations staff (Clinical Trial Managers and/or Clinical Document Specialists)
Participate in Clinical Science and DO initiatives
Responsible for the preparation and management of budget, resources and timelines for assigned clinical program. Responsible for program budgets up to $100M
Must have expertise in developing operational strategies and strong knowledge of ICH/GCP guidelines and multinational clinical trial regulations
Ability to work independently under general direction in a fast-paced environment
Must have excellent interpersonal, written, verbal, presentation administrative and computer skills, including familiarity with MS Project/project management software
Must have strong problem solving, organizational, management and interpersonal skills
Fluent in English (oral and written)
Moderate to high (25% - 35%) travel required

Senior Clinical Program Manager Resume Examples & Samples

Participation within client meetings to represent clinical program activity and performance
Manage program design, build and launch strategies applicable to the client
Ensure products and programs comply with contractual and regulatory commitments
Manage the creation and maintenance of program documentation and sales tools
Define and monitor key performance indicators used to monitor outcomes and manage product performance
Position must be located in California within commutable distance to Irvine and/or Sacramento
Licensed pharmacist with active license in good standing
Minimum of 5 years of professional experience within the pharmacy industry
Presentation experience, with client facing experience a plus

Clinical Program Manager Resume Examples & Samples

Current, unrestricted RN license in IA or Bachelor’s Degree in Social Work
3 Years of professional experience
Experience working with and coordinating services for the ID Population
Must reside in the State of Iowa
Experience with Iowa Medicaid
Understanding of the Iowa Administrative Codes

Clinical Program Manager Resume Examples & Samples

FP-1039 – an FGF ligand trap in a Phase 1b clinical trial in mesothelioma
Manage a group of related clinical trials within a molecule program; manage and communicate program timelines, budget, resources, and clinical activities and priorities. Proactively identify and mitigate program risk
Represent Clinical Operations on the Clinical Development Team (CDT); provide operational expertise and strategic input into the Clinical Development Plan (CDP) for assigned studies/program). Ensure CDT decisions and priorities are communicated to the Study Execution Team (SET) and Clinical Operations staff
Lead and collaborate with cross functional team(s) including the SET to ensure that scientific objectives of the CDP are met. Oversee the conduct of study activities for assigned programs
Oversee identification, selection, onboarding and management of study vendors including CROs, central /specialty labs, and imaging vendors. Provide study-specific training and direction/oversight to CROs, labs and vendors to ensure delivery against scope of work and key performance indicators
Partner closely with Clinical Development and other Functions to design and write clinical trial protocols. Oversee cross functional activities and SET and program level deliverables (e.g. DSUR, IBs, protocols, ICFs, CRFs, and CSRs.)
Review and approve study management plans (e.g. vendor oversight, TMF oversight, risk management, quality management, and monitoring) to ensure. Ensure team adheres to plans and conducts studies in accordance with ICH GCP and applicable regulations
Oversee and partner with external and internal stakeholders to ensure that clinical data from a variety of sources is appropriately captured, monitored, source-verified, edit-checked, reconciled and otherwise ‘quality assured&#8217
Oversee implementation of clinical systems and including CTMS, TMF, EDC, IxRS, and sample management for assigned clinical trials
Manage program budget; ensure accurate and timely review of invoices and payments, monthly accruals and forecast budget variances
Develop and oversee study quality metrics
Proactively drive SET deliverables and identify opportunities to accelerate programs
Partner with Director/ Associate Director to develop and implement operational strategy for assigned clinical trials (country selection, site selection, vendor selection, study timelines and budget)
Participate in recruiting, hiring and training Clinical Operations staff. Effectively delegate activities and oversee Clinical Operations team deliverables. Coach and mentor direct reports (i.e. CTMs/CTAs)
Lead departmental process initiatives
Other projects as needed
BA/BS degree, preferably in the life sciences; advance degree preferred
8+ years (CPM)/10+ years (Sr. CPM) of experience in all phases of clinical drug development filing INDs and NDAs/BLAs, 6+ years (CPM)/8+ years (Sr. CPM) with Masters or PhD
Proven ability to lead cross functional teams
Proven ability to successfully plan, implement, and manage multiple clinical trials for a molecule
Prior line management and program budget management (Sr. CPM)
Prior CRO and vendor management skills is a must
Strategic agility and flexibility
Excellent working knowledge of FDA & ICH/GCP regulations and guidelines
Ability to travel internationally up to 25%

Senior Clinical Program Manager Resume Examples & Samples

Conduct intake with consumers, using software on a tablet and PC, to establish rapport and trust as well as assess most urgent needs
Refer consumer to appropriate social services provider based on intake information, consumer socioeconomic status, and consumer?s schedule
Recognize local social service providers that connect with target population through community relations
Function as an advocate for consumers
5+ years of professional experience in social work/social services, the public sector, and/or working with an under-served population
1+ years of Customer Service and/or Retail experience
Competence in Microsoft Word, Excel, PowerPoint and Outlook
Ability to interact with diverse populations
Ability to travel up to 25% of the time within the local area
Ability to operate and manage in a complex matrix environment
Excellent relationship building skills; ability to interact successfully with numerous community partner organizations
Ability to deal effectively with ambiguity
Acts as a champion for myConnections program and members
Large, complex new-initiative or startup company experience
Previous experience with social services, employment services, and/or related activities
Experience building community partnerships
Ability to coordinate with multiple groups simultaneously to execute work plans for individuals with multiple obstacles related to social determinants, e.g.: housing, employment, transportation and food insecurities
Bilingual in English and Spanish or English and Arabic

Clinical Program Manager Resume Examples & Samples

Program development, value proposition, oversight, and day-to-day management for specialty pharmacy programs for a defined therapeutic category
Develop standard processes for implementing clinical programs and services
Provide support to Account / Sales Teams & Client Teams including presentations as the subject matter expert for a defined therapeutic category
Solves complex problems and develops innovative solutions
Performs complex conceptual analyses
Reviews work performed by other and provides recommendations for improvement
Report program performance against expectation and influence changes to programs to improve competitive position and optimize performance
Lead or help develop program or project scope statements, in consultation with applicable stakeholders (e.g., program / project charter, Statement of - Work, Business Vision Document)
Establish / apply quality objectives, criteria, standards and levels using appropriate quality management methods, with stakeholder input (e.g., key performance indicators, scope definition)
BA / BS degree in Healthcare, Business or related field and / or equivalent education and work experience
1+ years working in Specialty Pharmacy, Pharmacy Benefit Management (PBM), or health plan experience
1+ years’ experience in tracking, planning projects, working with large data sets and making data - driven analytical decisions
Intermediate level of proficiency with MS Project, Excel, Visio, and SharePoint
Demonstrated ability to communicate ideas clearly and concisely to leadership
Demonstrated ability to prioritize and balance multiple priorities and projects

Clinical Program Manager Resume Examples & Samples

Responsible for managing and tracking clinical projects that advance the objectives of Health Net’s strategic plan with key provider groups and/or hospital systems by supporting established committees and creating new work teams; including such activities as organizing and publishing agendas, documenting minutes, maintaining work plans and monitoring open action items
Works closely with the Regional Medical Director to analyze data and develop and implement key interventions to support the Triple Aim, including developing work plans, workflows, policies and procedures, and serving as workgroup leader when appropriate in order to execute initiatives
May use project management software to support initiatives
Five to seven years managed care, hospital or medical group experience, focusing on quality improvement, utilization management, or clinical operations
Project management experience at a medical group, IPA, or health plan setting
Experience analyzing and presenting data to drive outcomes

Clinical Program Manager Resume Examples & Samples

Act as representative of myConnections to both consumers and community partners
Refer consumer to appropriate social services provider based on intake information, consumer socioeconomic status, and consumer’s schedule
Understand the target population through experience by integration into to the local community
Collaborate with onsite Navigators to ensure coordinated plan is implemented for each consumer
Contribute to community education and outreach efforts
Bachelor’s degree in healthcare, social work, or related field
2+ years’ experience in healthcare, behavioral services, case management, or social services
1+ years’ experience in customer service/support
High level of interpersonal and conversational skills
Attention to detail and follow up
Medicare / Medicaid knowledge and experience
Resided within the local community for 2+ years
Familiarity with the resources available within the community
Field-Based experience
Bilingual (Spanish or Arabic)

Clinical Program Manager, Senior Resume Examples & Samples

Train the practices on technology that aid in improving member care, population health and affordability of care
Will install processes regarding member contact
Utilize data and technology for member statistic information
Bachelor’s degree OR RN with 5+ years clinical nursing experience
2+ years healthcare industry experience
Familiarity with physician medical record and scheduling systems

Senior Clinical Program Manager Resume Examples & Samples

Ensures business processes are in place to monitor and manage Special Populations, operational processes as defined by the state contract and / or national standardized model components
Develops, implements and monitors Special Program clinical processes metrics and monthly report cards for the various programs
Assists with development of policy, procedure, standard operating procedure, workflow, job aides, training materials for Special Programs or other health plan initiatives
Under the direction of the Health Services Director, acts as a contact to the State Program Managers, attend state meetings when needed, work with the State on policy decisions if needed, support implementation of the new policies at the health plan, create policies , SOP’s and JA’s, auditing of clinical programs
Develops and manages Special Program OR other clinical project / program work plans to achieve objectives
Facilitates cross-functional and / or cross-segment teams
Predicts emerging customer needs and develops innovative solutions to meet them
Solves unique and complex problems with broad impact on the business
Influences senior leadership to adopt new ideas, programs, and / or approaches
Registered Nurse, Social Worker or other individual with related Health Care or Clinical Operations and Program Management experience
3 - 5+ years clinical practice / professional experience (Preferably in Managed Care, Medicaid/Medicare Programs, Home Health, Hospice or Long Term Care)
2 - 3 years of Project / Program management experience
Demonstrated leadership and team development skills
Demonstrated ability to assist with focusing activities toward a strategic. direction as well as develop tactical plans, drive performance and achieve targets
Flexible to travel out in the community throughout the state of Nebraska
Bachelors Degree in Science or Business desired; Masters degree
Experience in Medicare or Medicaid Managed Long Term Care clinical programs
Experience in health care and insurance industry, including regulatory and compliance requirements
Analytics, database, project management experience

Clinical Program Manager Resume Examples & Samples

Builds collaborative relationships and ongoing communication with internal and external customers to improve or maintain delegate operational performance by applying end-to-end clinical services process assessment to identify risks or opportunities
Serve as the Clinical Interface / Liaison with UHN delegation teams, regulatory, compliance and external partners to coordinate trends, defects, remediation, and CMS concerns
Drives delegate implementation, remediation and process changes
Performs Clinical Operations Analysis (monitors and analyzes state regulations, CMS Regulations, and accreditation requirements; provides analytical support to clinical programs and outcomes)
Support documentation changes and process flows during clinical delegation implementations and alignments, which may include review of standards & processes with document revisions, as needed that incorporate applicable best practices with proven outcomes
Provides data and rationale to explain alternative options or processes to improve overall outcomes
Manages supports and provides subject matter expertise during internal project initiatives and internal or external audits
Assesses risks associated with implementation of new delegates
Collaborates with assigned Medical Director to develop strategic initiatives for the delegate, presents findings at JOC meetings and in Medical Management meetings to the Group’s Medical Director, completes analysis of information focused on assigned region and is always current on regional market
Acts as primary contact for the delegate to resolve general clinical and operational issues, attends regular internal meetings with Network Management and Sales staff
Attends and presents at external meetings such as the Joint Operating Committee meeting, Orientations, delegate training classes, and delegate Utilization Management meetings
Assists other internal departments with delegate issues, conversions and terminations
Degree in healthcare related field, strong clinical background (e.g. RN, LPN, Social Work, clinical analytics, etc)
Medical Management experience; Preferably in Utilization Management with all LOBs
Experience with CMS regulations preferred
Training or presentation experience preferred
Excellent presentation skills in person, via WebEx and conference call
Excellent interpersonal skills, serves as a leader or mentor

Clinical Program Manager Resume Examples & Samples

Manages the delivery of timely, appropriate, cost-effective and high quality services/ programs for assigned site
Assists physicians and department managers in short and long-range planning of psychotherapeutic/psychiatric social work programs/services that meet identified needs of members and purchasers
Evaluates the professional clinical practice of staff and provides professional staff with regular/appropriate training, direction, supervision and consultation
Evaluates effectiveness of program and services
Review/evaluates group therapy designs
Establishes group protocols
Conducts on-going program evaluation of individual and/or group modalities and, in concert with the department manager and/or Chief of Service, develops/maintains systems and processes for outcomes management/improvement and for identifying the need for revised and/or new clinical treatment programs, designs and/or protocols
May develop and implement policies, procedures and systems to ensure customer/ member/patient/purchase satisfaction and member/patient access
Participates in-or independently conducts - performance evaluation of professional staff
In concert with the Chief, and department manager maximizes and manages physical, fiscal and human resources and manages/reduces associated costs
Less than 50% of working time, may provide direct psychotherapeutic services to individual patients and/or patient groups

Clinical Program Manager, BHC Resume Examples & Samples

Experience with care of transgender members preferred
Familiar with transgender assessments and recommendations tor treatment
Familiar with WPATH guidelines

Clinical Program Manager Resume Examples & Samples

Overall responsibility for conducting IVD clinical trials
Active participation in development of study protocols and clinical study reports
Critical review of interim and final data
Lead cross-functional clinical team(s) in the execution of IVD clinical trials; may be responsible for multiple projects
Drive clinical timelines in line with regulatory strategy
Operate integrally with product core team to align clinical timelines and budget
Set and manage goals and timelines for projects encompassed by the IVD strategy; building and maintaining program timelines and interdependencies
Proactively communicate status of clinical trial deliverables to clinical management, core team, and other stakeholders including executive management
Facilitate appropriate interim and final reviews of study data in preparation of regulatory submissions
Design and maintain study budget and performance metrics
Manage clinical teams through plans (mitigate clinical trial risk)
Execute, negotiate and maintain supply agreements with suppliers
Manage and facilitate resolution of clinical trial risks or issues; plan and implement contingencies as appropriate
Meet with cross-functional Clinical Affairs team members to prepare team meetings, capture meeting minutes and assign key action items with single points of accountability
Interact with RA/QA in responding to audits and FDA inquiries
May supervise Clinical Trial Leads
Demonstrated excellence in leadership. teamwork and communication skills including relationship building skills with team members, peers, and senior leaders
Broad and thorough understanding of clinical trial process including: study design and conduct; clinical data management systems; clinical trial management systems; data analysis; and data reporting and interpretation and project finance accounting
Able to manage numerous projects/conflicting priorities, and to be flexible when priorities change
Working knowledge of FDA Device guidelines and regulations
Skilled in use of Microsoft suite
Degree in life science or health-related discipline
BS with 8+ years of experience, or MS with 5+ years of experience, or PhD with 3+ years of experience
8+ years of experience in clinical project/program management, clinical trial practices and regulations
Experience leading cross-functional teams and projects
Experience in IVD (preferred), biotechnology, medical device, or pharmaceutical industry

Clinical Program Manager Resume Examples & Samples

Perform the activities of motivating, monitoring, and managing Clinical Study Sites worldwide and ensure site compliance with protocol and overall study objectives, SOPs, applicable regulations and ICH/GCP guidelines
Conduct site qualification, site initiation, routine monitoring and study close out visits and generate the corresponding reports
Establish effective relationships with clinical investigators and staff
Assist Clinical Study Sites with IRB/EC submissions and ensure collection and review of required essential study documents and reports
Work proactively with data management team to identify and resolve data discrepancies
Track study progress using study tracking tools, ensuring timely and quality updates to the system used
Provide study and site status reports and make any necessary recommendations for mitigation and contingency planning
Participate in the design and development of clinical trial protocols, case reports forms, and other study documentation
Assist with contract negotiations, site budgets and payments as needed
Assist with CRO and vendor management, as needed
Develop strong working relationships and maintain effective communication within the Clinical Department as well as other functional departments within the company
Participate in other project or departmental tasks as needed to ensure studies and publications are completed on time and within budget
Manage, mentor and train junior staff and project team, as needed
Bachelor’s degree or equivalent in the life sciences or related field required; advanced degree (Master’s or above) preferred
1-3 years’ experience as a CRA including the ability to interact effectively with investigators and cross-functional teams
Knowledge of GCP, GLP, ICH guidelines and other US and international clinical regulatory requirements
Demonstrated ability to organize and present scientific information (e.g., clinical study results) to internal and external audiences
Strong work ethic and demonstrated ability to deliver assignments on time
Professional use of the English language both written and oral is required

Senior Clinical Program Manager Telecommute Resume Examples & Samples

Assesses and interprets customer needs and requirements
Works with minimal guidance; seeks guidance on only the most complex tasks
Coaches, provides feedback, and guides others
Acts as a resource for others with less experience
Advanced Degree or Certifications
Previous experience with quality process measures
Working knowledge of Medicare / Medicaid including Altruista, CareOne and Plan of Care

Clinical Program Manager, Orphan Indications Resume Examples & Samples

Directly and/ or through management of Clinical Trial Managers (i.e., Study Managers), lead and manage the Development Operations (DO) extended team to ensure timely and optimal planning, execution and reporting of DO responsibilities and deliverables
Deliver and manage the operational plan for assigned program including budget, resources and timelines in support of global project team
Ensure integrated and optimal quality at the level of investigative sites, data and DO deliverables in collaboration with other DO team members and functions
Collaborate with global project team members (e.g., DO, Statistics, Medical Writing, Medical Sciences) to ensure integrated and consistent approaches and performance within DO
BA/BS with at least 5 years clinical trial management experience, or MA/MS with at least 3 years clinical trial management experience
Must have experience in conducting multi-country clinical trials and strong knowledge of protocol and clinical drug development processes, clinical study design, study planning and management, and monitoring

Clinical Program Manager Resume Examples & Samples

Facilitate team coordination and work flow for projects
Monitor project timelines and resources available
Communicate up-to-date information regarding project progress to all relevant interested parties, including Senior Management
Obtain and negotiate contracts with vendors for content and pricing
Lead project team meetings
Assist in protocol development and CRF design
Perform site visits as needed
Excellent organizational skills, including the ability to handle multiple assignments
Knowledgeable about GCP, ICH, and FDA regulations
Experience managing project budgets

Clinical Program Manager, Senior Resume Examples & Samples

Manage a portfolio of 5-7 primary care physician practices
Maintain weekly visits with assigned practice portfolio
Facilitate and train physician practices on processes for effective member contact
Train and support practices in the use of technology that aids in improving member care, population health and affordability of care
Improve convenient access to care for the practices’ Health Plan population
Help practice leaders understand overall capacity/demand for appointments and visit patterns by practice and assist the Practices in implementing process improvements to increase same day visits and reduce no show rates
Reduce inappropriate ER use for the practices’ Plan population
Collaborate with practices to use daily hospital ADT and daily ER notifications to engage members to use PCP for primary care
Reduce avoidable admissions and readmissions for the practice Plan population
Use predictive modeling analyses of practice population risk and population total costs of care and assist practices in identifying cohorts of high risk/high cost patients for focused improvement initiative
Proficient in facilitating presentations to peers and leadership
Strong interpersonal skills that enable relationship building
Ability to analyze results of outcome measures and assist physician practices in creating solutions
Ability to maintain a professional home office setting
Demonstrated evidence of innovative thinking and program development for healthcare system improvement
Experience working with databases, Access or Excel spreadsheets

Clinical Program Manager Resume Examples & Samples

Leads the development of clinical program enhancements and better practices. Assist with development, enhancement, and maintenance of operational functions, policy and clinical support and provider education
Develops, implements, and monitors project plan requirements and timelines, ensures all necessary support, tools and technology are available, and follows up as needed. Meets with business process owners and other appropriate personnel to identify the project's goals, objectives, critical success factors, and success measures
Works closely with teams to ensure consistent delivery of approved programs to their client. Ensures operations are standardized at the fullest extent possible. Provides overall project coordination for the contract's clinical and operational functions
Oversees/coordinates implementation of new specialty programs and serves as liaison between the company and customers as needed
Revenue Generation - Works jointly with Account Manager to ensure revenue goals, administrative expenses are managed
Develop strong relationships with key contacts at client level
Develop strong relationships and contacts within Magellan that are supportive of the achievement of increased revenue goals
Supports other functions as requested throughout the program development lifecycle including finance, outcomes, communications and IT
Communicates frequently, either by phone or in person, with client to report program progress, establish priorities and maintain positive client relationship. Responds to client?s requests for information. Assesses, investigates and resolves difficult issues to achieve customer satisfaction

Clinical Program Manager Stroke Resume Examples & Samples

Develops and maintains a comprehensive, effective clinical program which meets regulatory standards. Collaborates with physicians in the development of standardized patient care plans. Promotes comprehensive treatment approach working with multidisciplinary team to effectively manage patient care through the continuum and provide quality outcomes
Monitors and measures care plan results and patient outcomes. Reviews trends, identifies opportunities and provides leadership with analysis and recommendations for process improvement across entire episode of the patient process. Enhances patient experience across the overall continuum of care
In collaboration with other department leaders, assists in oversight of ongoing daily operations. Researches and recommends changes and improvements with a primary focus on patient outcomes. Oversees resource utilization regarding staff, fiscal management, and quality patient care
Develops, coordinates and oversees community education program. Assesses clinical staff training needs and implements training programs to ensure clinical competence
Develops and monitors financial budget of the program ensuring appropriate utilization of resources including staff, materials and equipment
Assists with selection, evaluation and management of program staff members and effectively facilitates direct patient care for the ongoing viability and success of the program

Clinical Program Manager Resume Examples & Samples

3+ Years of experience working in the healthcare industry
Experience working with and coordinating services for the elderly population
Knowledge of nursing facilities PASRR

Clinical Program Manager Resume Examples & Samples

Plan, manage and execute clinical programs
Responsible for the project management of a clinical program/study
Develop overall feasibility concept and enrollment plan with input from COMs
Ensure regulatory compliance and GCP compliance
Responsible for oversight of TMF with periodic audits
Responsible for leading vendor selection and management including issue escalation
Develop and implement Study Management plan and all associated documents (i.e. vendor oversight plan)
Collaborate with CTS team to plan and coordinate IMP and non-IMP supplies
Plan, lead, and facilitate SET (internal) meetings as well as act as the CSL lead for vendor meetings
Ensure monitoring plan is developed and consistently executed in collaboration with COMs
Develop proactive strategy and corrective action plan to address study issues in collaboration with SET and COMs
Consults with COMs for strategic selection of countries and sites
Facilitate and coordinate communications with external provider
Ensure Clinical Operations team and external provider receive study specific training
Report key study performance information, including study start-up metrics, enrollment, data collection timeliness/quality
Provide operational input into the overall program strategy
Act as the primary point of contact for internal groups outside of CRD (including
As a guide, a minimum of 6+ years’ relevant clinical research experience within the pharmaceutical industry
Experience in overseeing global clinical trials (pharmaceutical or research institute)

Regional Clinical Program Manager Resume Examples & Samples

BSN Required
At least five (5) years clinical experience required
Current nursing license in the state in which they practice
Multi state license may be required in some instances pursuant to the development of outreach programs
Master’s degree in Healthcare preferred
Prior and current experience within TeleHealth industry strongly preferred
Four years’ experience in program management implementing multi-departmental or enterprise solutions strongly preferred

Clinical Program Manager Resume Examples & Samples

Develop relationships and enhance partnerships with Specialty pharmaceutical manufacturers
Present clinical services and therapy capabilities to externalclients to secure product access and gain incremental market share
Monitor the pipeline and manage all clinical aspects of new product launches
Develop and deliver clinical education and training to internal and external customers

Clinical Program Manager Resume Examples & Samples

Link the development of clinical solutions to the contracting and account management strategies to meet or exceed HM HCS objectives
Identify, analyze and interpret appropriate sources of PI data, quality indicators, benchmarks and best practices to ensure the collection of meaningful data demonstrates processes and outcomes of post-acute care programs
Contribute to managing the portfolio of care-related initiatives being developed from a business and/or clinical perspective, while managing critical collaborative partnerships with external customers

Senior Clinical Program Manager Resume Examples & Samples

Support the Sr. Medical Director in designing clinical program solutions that work to improve/drive patient outcomes in alignment to business objectives and plans. Develop and create improved clinical care strategies that improve patient outcomes
Coordinate clinical program teams to establish processes for measuring and comparing program performance. Assure quality of information through business case and application level testing, and validate results
Identify, analyze and interpret appropriate sources of PI data, quality indicators, benchmarks and best practices to ensure the collection of meaningful data demonstrates processes and outcomes of PAC programs
Organize, display and report data in a manner that facilitates the planning, development and evaluation of projects and programs as directed by the Sr. Medical Officer
Other duties as assigned or requested

Clinical Program Manager Resume Examples & Samples

Delivering high levels of customer retention
Establishing high levels of customer service, delivering program specific KPIs (Key Performance Indicators) and account relationship development objectives
Contributing to business growth and profitability targets by identifying scope enhancements from existing programs and new business opportunities through client engagement activities
Contribution to divisional revenue and profit targets
Delivery of assigned account plans relating to existing and future company service offerings through provision of strategic account management support to global clients
Mapping timeline and project plan for program launch
Participation in client meetings around scope and set-up
Creating operational procedures as it relates to pharmacovigilance workflows, order processing, logistics, regulatory scoping, client set-up documents, etc., for review by PDs
Be responsible for program related updates ensuring relevant teams are trained as appropriate on changes to programs
Support PDs in producing documentation for assigned accounts e.g. update action item lists and minutes from client calls
Achievement of account specific budgets in line with forecast
Creating reports on activity, performance and outcomes against contracted program requirements/KPIs where appropriate for review by PDs
Analysis of client satisfaction outcomes identifying solutions to meet client requirements
Deliver Program Management solutions to support new and existing business growth
These solutions will be measured by: Timely and accurate contribution to program scoping, bid defense and contract reviews, Delivering to agreed client contract implementation requirements across all business functions, Identifying operational efficiencies and program enhancements,
Deliver growth of existing account performance by establishing effective relationships at management levels within the client organization, New product and service identification for referral to BD/PD

Clinical Program Manager Resume Examples & Samples

Develop and maintain integrated, cross-functional program timelines to identify and communicate inter-dependencies and critical path activities
Facilitate Cross-Functional Project Team meetings using meeting management best practices to drive cross-functional communication, timely and effective decision-making, and successful execution of program objectives
Develop and maintain integrated, cross-functional program timelines to identify and communicate interdependencies and critical path activities
Proactively identify and prioritize program opportunities and risks; develop and monitor action and mitigation plans
Track project activities, stay on budget and communicate status to management and accounting
Oversee execution of contracts and agreements for outsourced activities with multiple vendors, CROs, CMOs, and business partners
Provide clinical operations or regulatory project management support as needed to ensure program timelines are met
BS/BA; MSc and/or MBA preferred
5+ years overall experience in drug development (can include experience with bench science, CMC, clinical development, etc.) with a minimum of 3 years program management experience in the biopharmaceutical industry required
Strong understanding of drug development process for complex biologics essential, including clinical and non-clinical study design and execution, etc
Exposure to early-stage programs (pre-clinical though Phase I/II proof-of-concept) essential
Exposure to late-stage programs (Phase II/III pivotal) would be a big plus
Proven ability to balance the strategic needs of the program with tactical day-to-day activities
Ability to analyze complex activities and information to help guide decision-making that meets the overall objectives and long-range plans of the organization
Outstanding communication, planning and organizational skills
Successful track record of creating and managing accurate timelines and the use of project software
Ability to quickly gain an understanding of the complexities of gene therapy
Highly collaborative team player who fosters open communication and is able to facilitate urgent needs

Clinical Program Manager Resume Examples & Samples

7-10 Years with Bachelors (Clinical or Scientific) or 5-8 Years with Masters or 3-6 with Doctorate or 0-3 Years with MD*, DVM* (*Board Certified)
Proficient knowledge of clinical research study processes and study design; demonstrated ability to incorporate and adhere to Good Clinical Practices and regulatory standards
Proficient knowledge in word processing, spreadsheets, and/or database applications (e.g., MS Word and Excel)
Knowledge: Applies mastery of in-depth knowledge in one job family or broader expertise in most areas of a job function
Problem Solving: Develops solutions to complex problems that require the regular use of ingenuity and creativity. Ensures that solutions are consistent with organization objectives
Discretion / Latitude: Work is performed without appreciable direction. Exercises considerable latitude in determining deliverables of assignment. Completed work is reviewed from a relatively long-term perspective, for desired results. May provide guidance about work activities to colleagues
Impact: Contributes to defining the direction for new products, processes, standards, or operational plans based on business strategy with a significant impact on work group results. Failure to obtain results or erroneous decisions or recommendations would typically result in serious impact on customers and/or results and considerable expenditure of resources
Liaison: Frequent interaction with internal or external contacts at various organizational levels concerning ongoing operations or changes relating to processes or programs. Leads briefings with internal and external contacts

Clinical Program Manager Resume Examples & Samples

Responsible for planning, execution and evaluation of large/complex program initiatives to improve quality performance in Medicare line of business with emphasis around the Star Program
Develops and monitors measurement strategies for large change and improvement initiatives
Manages program(s) from initiation/pilot phase through delivery/spread and monitors for continuous improvement
As part of a broader QI team, influences the business unit, strategies and objectives
Provides input into designing strategies for alignment with business unit goals and objectives
Manages program(s) from initiation through delivery and monitors for continuous improvement
Participates cross-functionally in business planning to support business unit strategy
May assist in the planning and direction of budgets
Responsible for assembling the internal Star project team, assigning and monitoring work of team members and providing guidance and leadership
Knowledge of company products, functions, marketing and/or service policies and procedures
Serve as a quality expert with internal constituents to drive Star-related program development and outcomes success
Educate and work with external partners and participating practices as needed to identify innovation opportunities and adopt Star-related improvement actions
Some travel is required
Registered Nurse (RN, LVN, BSN), PA or Master's degree (MPH, MHA, MSW) preferred; or equivalent experience
At least 5 years of experience or equivalent combination of experience and education
2-4 years of healthcare experience in Quality Management, Utilization Management, or Case Management
Previous project/program management experience in tracking, planning projects, working with large data sets and making data - driven analytical decisions required
Knowledge of NCQA accrediting body requirements desired
Experience with Medicare Star Program, Dual Eligible, Special Needs or Medi-Cal quality improvement requirements preferred
Experience with quality improvement/process improvement techniques required
Experience in the CA delegated model or with highly integrated clinical delivery systems preferred
Intermediate level of proficiency with MS Excel, Visio, and Power Point

Clinical Program Manager Resume Examples & Samples

Assists in design and development of action plans to support compliance with measures indicators and provides support and educational resources to departments and services relative to core measures quality assessment and improvement processes
Assists in establishing and implementing short and long term goals, objectives, policies and operating procedures for core measures programs
Provides technical assistance, resource services, consultation and education to clinical departments relative to core measures activities
Promotes an interdisciplinary approach in patient care delivery
Provides timely status reports of results of quality monitoring relative to areas that are assigned including identification of patterns and trends that require actions
Participates in the development and implementation of continuous quality improvement programs

Clinical Program Manager Resume Examples & Samples

Assists in the performance appraisal process of designated Nursing staff, when applicable
Licensure: New York State License with current registration as a registered professional nurse
Education: Baccalaureate Degree in Nursing is required. Master’s degree preferred
Certification in specialty area preferred
RN License required

Clinical Program Manager Senior Resume Examples & Samples

1) Develops and manages complex/major cross-functional planning and implements or oversees the implementation of new, expanded, or improved internal and/or external clinically-oriented health management projects ensuring they comply with regulatory and accreditation requirements. Projects often involve several partners and may require collaboration with external entities, requiring expertise in developing and maintaining strong business relationships as well as developing and implementing communication plans
2) Develops and continually updates program or project plans, timelines, and deliverables while coordinating multiple sub-processes to develop, expand or improve programs
3) Drives to and delivers high quality solutions with aggressive timeframes and high level stakeholder satisfaction
4) Develops and implements a communication plan in conjunction with leadership and to support the initiative including communicating to key internal stakeholders
5) Uses established standards for work methods, data analysis which may include barrier analysis, measurement plan, performance measures, and other resources to support the project. Develops new standards as needed and appropriate
6) Develop presentations highlighting findings, analysis, recommendations and action plans
7) Develops and maintains positive relationships with key stakeholders both internal and external which may include healthcare providers, collaboration partners, and various non-profit organizations, etc as needed to collaborate on projects designed to improve health outcomes
8) May develop and manage vendor contract(s); manages project budget(s)
9) May participate in the coaching, mentoring, and training of other employees
10) Perform other accountabilities as assigned

Clinical Program Manager Resume Examples & Samples

Lead the identification of clinical areas for product development
Lead the development and execution of clinical programs to meet clinical, market, and member needs, including clinical pilots with strategic partners
Maintain competitive industry knowledge of market differentiating clinical strategies
Analyze utilization trends and quality outcomes performance and provide creative solutions to support cost containment, quality improvement and regulatory compliance needs
Assess, critique and select vendor clinical offerings most suited for Regence clinical and business goals
Negotiate, monitor and manage vendor performance, manage inter-departmental coordination to ensure alignment of strategic goals and streamlined member experience
Participate in pharmacy clinical strategies development, provide input for formulary development, policy development, benefit design and utilization management initiatives
Evaluate, document and manage clinical product offerings on a regular basis to maintain a competitive product portfolio with strong ROI
Design and improve clinical and operational processes to support strong and consistent delivery of top notch member experiences and operational efficiency
Provide consultative expertise for strategic provider partners, plan leadership, purchasers, Quality Incentive Plan participants, contracted pharmacy partners and other Health Plan stakeholders as needed
Mentor, coach and evaluate pharmacy students and residents

Clinical Program Manager Resume Examples & Samples

Develops, implements and evaluates program services and initiatives
Hires, trains, develops and evaluates staff. Assigns tasks. Prioritizes and coordinates work
Monitors and adheres to budget. Approves or monitors expenditures, purchases and other actions to insure compliance with budget guidelines
Minimum Qualification: Three years of experience directly supervising staff
Preferred Qualification: Physician practice management

Clinical Program Manager Resume Examples & Samples

Understanding of the clinical, regulatory, and commercial requirements for early and late stage drug development
Knowledge of clinical operations and the regulatory process
Knowledge of global drug development, registration, and market launch requirements
Thorough understanding of each functional area’s role and contribution to the development process
Ability to develop and implement cross-functional global drug development plans (GDDP), including strategic assessment of budgets and timelines
Solid computer skills with MS Project, Word, Excel, PowerPoint, and Outlook
Excellent interpersonal, communication and negotiation skills
Bachelor’s degree + 5 years of project or program management experience in the pharmaceutical industry

Clinical Program Manager Resume Examples & Samples

Working closely with Resources Coordinator, team leads, within each group to directly manage APP, RN and non-clinical staff in each program
Responsible for daily operations within each team, payroll, hiring, direct supervision, professional development and performance monitoring of all direct reports
In close collaboration with the Director, Professional Practice and Development for APPs, develop and monitor plans for professional development of all APP direct reports
Ensure workflows result in seamless coordination of care across the BCVI spectrum including pre-op/pre-procedure testing and work up, outpatient appointments, inpatient management, follow up and successful transition back to home
Ensure quality oversight of programs and patient satisfaction of programs
Coordinate research efforts related to programs
Coordinating the onboarding process of newly hired advanced practice providers, nurses and other ancillary staff within BCVI programs where there is not a direct reporting relationship
Identifies and pursues business activities which achieve best patient experience and best people goals, enhance reputation, market and clinical leadership, improve financial performance, and enhance capability in cardiovascular disease
Assist in the development of strategic plans aimed at continued BCVI growth with favorable outcomes
Analyzes potential, risk/reward, resource requirements, and financial benefit to proposed BCVI initiatives through complex analysis and research of market, financial and internal factors
Develops, implements and manages internal measurement and monitoring systems that demonstrate the effectiveness of business initiatives in enhancing patient care, access, volumes, market share, financial performance, and program reputation within the assigned cardiovascular areas
Works with multiple departments i.e. Business Development, Professional Services, CV inpatient units, Surgical Service, and key leadership across organizations to develop processes, internal statistics, market data, and financial performance data as needed to evaluate existing programs for their fit with corporate mission, to advance and achieve BCVI goals, ability to meet key strategic criteria, and potential for improvement
Work collaboratively with the BCVI outcomes management program and operational managers to systematize the monitoring and management of BCVI programs
Bachelor Degree in Business Administration, Healthcare Management, Communications or related field
Current IL license as a Registered Nurse, Advanced Practice Nurse, or Physician Assistant. If APN: certification as an Advanced Practice Nurse by a national certifying body
Master’s degree in MBA or MHA; required in place of work experience
Certification in area of specialty or administration

Senior Clinical Program Manager Resume Examples & Samples

Ensures business processes are in place to monitor and manage Special Program operational processes as defined by the state contract and / Or national standardized model components
Develops, implements, and monitors Special Program clinical processes metrics and monthly report card
Assists with development of policy, procedure, standard operating procedure, workflow, job aides, training materials for Special Program or other health plan initiatives
Develops and manages Special Program OR other clinical project/program workplans to achieve objectives
Facilitates cross-functional and / or cross - segment teams
Current, unrestricted SW or RN license in the State of KS
2+ years of HCBS (Home & Community Based Services) Waiver experience, OR 2 years of project or program management experience, OR 2 years Kansas Medicaid experience
Ability to interpret, organize and apply regulations

Clinical Program Manager Resume Examples & Samples

Training and mentoring staff on our clinical platform to ensure metrics are met and tracked accurately
Provide excellent customer service to our community partners, work closely with provider relations to promote and deliver our care model, as well as comply with our governmental contract requirements
Compliance responsibility, coordinate meetings at agencies, handle clinical issues and work with clinical region
Travel to offices of our contracted providers and to meetings with the state of Virginia
Develop policies and procedures to ensure adherence to the care model
Bachelor’s Degree in Social Work, Public Health, Health Administration and / or an RN with a current and unrestricted license in the state of VA
Experience in home health care, case management, provider relations, community health and / or managed care
Proficient in MS Office programs and Internet
Ability to travel locally, regionally and throughout the state of VA when needed
Supervisory / leadership experience
Clinical quality experience
Experience in the creation and delivery of presentations
Government contract experience

Clinical Program Manager Ob Resume Examples & Samples

Coordinates core measures and clinical intervention compliance activities in conjunction with Nursing, Medical and Quality Leadership
Provides coordination and leadership in the execution of day to day program activities, as appropriate to program objectives and areas of expertise
Oversees the collection, compilation, and analysis of clinical program activity data
Participates in and conducts process improvement analysis where applicable
Serves as a resource for patients and their families. Acts as a patient advocate utilizing the Patient Bill of Rights
Prepares reports and analysis associated with the institutions core measures programs i.e. senior management reports, departmental and clinical service program evaluation, quarterly reports, etc
Collaborates with other members of the health care team in the development, implementation, and ongoing review of policies, procedures, and standards of care for designated patient populations
Demonstrates knowledge of hospital, departmental and care center standards, policies, procedures and guidelines as well as regulatory agency standards. Assures readiness for Joint Commission and other agency surveys and presents related programs during Joint Commission and other agency visits
Participates in quality management activities including identifying and communicating issues of performance improvement and risk in a timely manner
Assists in the performance appraisal process of designated Nursing staff

Behavioral Clinical Program Manager Resume Examples & Samples

Drive patient care improvement strategies for Achievements in Clinical Excellence (ACE) facilities
Data analysis and strategy development for implementation and ongoing monitoring of facility performance, metrics and tiering. Additional data analysis as requested to provide a look at underlying root causes for performance degradation
Conduct facility partnering meetings on monthly basis. Attendance at such meetings typically includes facility CEO, Medical Director and other key senior leaders at the facility
Participates in Affordability team discussions regarding data findings and financial trends. Reports on analysis of data and provides action plans for mitigating financial loss to affordability leaders. Works directly with facilities in collaboration with Clinical, Affordability and Network teams to employ these strategies
Employs Facility Practice Management interventions to drive facility improvement. These interventions are inclusive of but not limited to additional data analysis, collaboration with other Optum departments, strategic thinking and conversations with facility staff about negative trends in data. These FPM interventions also involve a significant working partnership with the OPTUM MD assigned a given facility
Collaborates with Communications Director and Communications Specialist to develop and maintain both internal and external communications regarding ACE and its expanding role
Identify facility concerns and communicate these to Clinical, Affordability and the Communications team
Direct responsibility for all ACE facilities’ interventions that identify plans and strategies to improve performance across effectiveness and efficiency measures
Acts as SME, Data Analyst and key formulator of strategy and interventions for various state-wide initiatives for C & S, Clinical, Affordability, Account Management, Product and other departmental projects
Ability to be flexible and capable of dealing with a constantly evolving department to include such programs as ACE ED, ACE SUD and the expansion of the ACE OP Program
Liaison with existing regional network teams and RVP’s as needed to gather pertinent information, share information and communicate all pertinent information related to development of the ACE program
Participate in the ongoing identification, research and implementation of additional quality metrics for ACE. These metrics are often driven by the business needs of various OPTUM departments such as Affordability, Product and Account Management
Responsible for compliance with network requirements, network assessment and program / product implementation
Verify with current Network staff any standing relationships that may need to be leveraged and include Network staff where appropriate
Liaison with Facility Contracting staff to identify any contractual issues that may be pertinent to facilities
Functions as OPTUM lead for ACE enterprise-wide team to improve quality and cost/efficiency in network facilities
Participate in oversight of quality and efficiency monitoring of Affordability activities for facilities within the Optum network identified as part of the ACE program
Liaison to ACE Oversight team (Clinical, Network, and Regional Medical Director) to implement and maintain program goals, including monitoring significant data trends that require joint meetings/calls with facilities. Collaboration with ACE Oversight team to plan, structure and lead facility partnering meetings
Participate in the development and implementation of incentives that focus on rewarding excellent facility performance
Development and oversight of the ‘concierge approach’ with facilities. Links facilities with appropriate staff to resolve issues (i.e. claims, contracting, etc.)
Licensed Bachelors or Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2 or more years experience in behavioral health
Licenses must be active and unrestricted
Minimum 5 years managed behavioral care experience. Familiarity with OPTUM processes a major plus
Previous Care Advocate experience
Proficiency in Microsoft Excel
Data Analytics experience
Ability to think critically, pull data reports and interpret data
Prior work experience with a Behavioral Care facility, Partial Hospitalization program, Intensive Outpatient program, Community Mental center, etc. is a plus

Senior Clinical Program Manager Resume Examples & Samples

Educates providers and office staff on proper clinical documentation, coding, and billing practices, CMS mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria, to drive quality improvement
Documents and refers providers' non-clinical / service issues to the appropriate internal parties, to include Provider Relations and the Plan Chief Medical Officer by analyzing provider records and maintaining database
At least 6 months of HEDIS experience
Reliable transportation to travel to physician offices locally up to 50% of their time

Disease Management Clinical Program Manager Resume Examples & Samples

Develops disease state and therapy overview to facilitate understanding of therapeutic area & clinical unmet need & enable performance comparisons for new & emerging therapies
Conducts primary research soliciting KOL input to support current physician view of disease, patient populations & opinion of new & emerging therapies
Participates in the design and development of disease management platforms providing clinical expertise as it relates to a specific disease state across the care continuum
Develops & communicates clinical value proposition with succinct, data-driven messaging to support corporate decision making across functions & levels of organization
Conducts ongoing monitoring of priority areas by proactively tracking priority therapeutic areas through literature & conference attendance & communicating updates to broad cross-functional team triggering a reassessment of strategy if game changer occurs
Manages key project initiating, planning, executing, controlling, and closing processes; develops and implements project plan as needed
Engaged in initial diagnostics on behalf of CMC for disese management

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