Clinical Trial Project Manager

Clinical Trial And Utilization Program Specialist

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

The Clinical Trial And Utilization Program Specialist plays a critical role in supporting the Utilization Management (UM) and Medical Policy teams by developing, implementing, and maintaining policies and procedures that govern clinical trial oversight and utilization management. This position ensures compliance with regulatory standards, ethical guidelines, and organizational policies, while facilitating cross-functional collaboration to enhance operational efficiency and clinical integrity.

Essential Functions :

• Conduct daily reviews of inpatient and outpatient utilization cases using InterQual criteria and internal policies.
• Collaborate with physician reviewers as needed to ensure clinical appropriateness.
• Partner with Care Management and Appeals & Grievance teams to ensure seamless coordination and resolution of member cases.
• Serve as a liaison between medical directors, policy developers, and UM staff.
• Design, implement, and monitor workflows for clinical trial review and documentation.
• Track protocol statuses, regulatory submissions, and trend analyses.
• Contribute to the creation and revision of medical policies based on clinical evidence and regulatory updates. Support the Medical Policy Committee by preparing materials and facilitating discussions.
• Participate in planning and development of system upgrades and enhancements to support UM and clinical trial processes.
• Lead the development, implementation, and ongoing maintenance of policies and procedures related to clinical trials and utilization management.

Qualifications :

Knowledge, Skills, and Abilities :

Working Conditions :

Remote Type : Remote

Work Location : 399 Revolution Drive

Scheduled Weekly Hours : 40

Employee Type : Regular

Work Shift : Day (United States of America)

Pay Range : $62,004.80 - $90,750.40 / Annual

Grade : 7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and / or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources.