Lead Director - Clinical Innovation

Location: Remote – US-based candidates only, no visa sponsorship available.

About the role

This role supports clinical priorities focused on quality, patient-centered outcomes, and effective care delivery. You will collaborate with clinical leaders, operational teams, and cross-functional stakeholders to improve standards, workflows, and execution. The position offers the opportunity to strengthen care quality, team performance, and measurable outcomes within a healthcare environment.

Responsibilities

• Evaluate performance metrics and market trends to enhance clinical outcomes
• Lead strategic analyses and business case development for Utilization Management (UM) strategy
• Drive portfolio planning for modernization initiatives and funding recommendations
• Collaborate across teams to establish a multi-year UM modernization roadmap
• Identify and implement automation opportunities using AI and analytics
• Develop KPIs and frameworks to measure impact of automation initiatives
• Provide governance for innovation pilots and transformation programs
• Build relationships with senior leaders to advise on UM strategy and performance
• Mentor and develop a high-performing team while fostering a culture of innovation

Qualifications

• 10+ years of leadership in strategic planning and innovation within healthcare or managed care
• Deep understanding of Utilization Management and health plan operations
• Experience in developing enterprise strategic initiatives from inception to execution
• Strong analytical skills for business modeling and financial analysis
• Proven track record in managing complex enterprise portfolios and strategic planning
• Familiarity with advanced analytics technologies like SQL and Python
• Understanding of automation and AI workflows in operational improvement
• Ability to influence senior leaders and stakeholders effectively

Pay

$100,000 – $231,540 annually

Benefits

• Comprehensive medical, dental, and vision coverage
• Paid time off to encourage work-life balance
• Retirement savings options to prepare for the future
• Wellness programs to support overall well-being
• Additional resources and support based on eligibility