Clinical Trial Project Manager

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

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

Education

• Bachelor's Degree required
  
  

Experience

• At least 3-5 years of progressively more responsible experience in a research-related field required
• Prior Supervisory experience preferred
• At least 3 years of experience in a managed care setting is highly preferred
• Experience with clinical trial management is highly preferred
• Utilization Management experience highly preferred
  
  

Knowledge, Skills, And Abilities

• Expertise in clinical inpatient and outpatient utilization management reviews utilizing InterQual, company policies and procedures, and other resources as determined by review, including physician reviews as needed.
• Expertise in clinical inpatient and outpatient care.
• Proficiency in policy and procedure development.
• Deep understanding of clinical trial protocols and compliance.
• Excellent communication and interpersonal skills.
  
  

Additional Job Details (if Applicable)

Working Conditions

• This is a remote role that can be done from most US states
  
  

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.

EEO Statement

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 at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.