Healthfirst

Senior Project Manager- Clinical Transformation

Healthfirst  •  $105k - $188k/yr  •  United States (Onsite)  •  4 hours ago
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Job Description

The Sr Project Manager Clinical Transformation (Sr PM) uses their deep knowledge of clinical operations business processes, regulations, and technology to lead large-scale, complex initiatives focused on the implementation of Utilization Management (UM), Care Management (CM), and related clinical operations platforms across Healthfirst. The Sr PM is accountable for delivering complex software implementation and transformation programs from initiation through stabilization, ensuring operational adoption, regulatory alignment, measurable business outcomes, and cross-functional coordination. The incumbent drives implementation, governance, operational readiness, vendor coordination, clinical workflow integration, and delivery accountability for technology-enabled transformation programs in support of the Clinical Operations team.

Duties and Responsibilities:

  • Lead end-to-end implementation of AI-enabled clinical platforms supporting UM, Care Management, prior authorization, population health, or related clinical operations
  • Manage large-scale transformation initiatives involving workflow redesign, system integration, data migration, operational readiness, and change management
  • Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes
  • Manage a high-volume portfolio of large, cross-functional projects with significant operational, clinical, technical, financial, and regulatory interdependencies
  • Translate operational and clinical requirements into executable implementation plans with technology teams and vendors
  • Ensure AI solutions align with clinical operations, compliance standards, audit requirements, and user adoption objectives
  • Partner with executive and senior leaders to drive alignment, facilitate decision making, remove barriers, and ensure accountability across stakeholder groups
  • Standardize and apply project management best practices, tailoring methodologies as appropriate to initiative complexity and scope
  • Establish and maintain project governance structure, including steering committees, status reporting, risk management, and escalation pathways
  • Proactively identify and mitigate risks related to cost, scope, timelines, regulatory compliance, operational disruption, and organizational readiness and adoption
  • Monitor and report on initiative performance, operational impact, financial benefits, and realization of return on investment
  • Ensure projects are executed in accordance with Healthfirst policies, regulatory requirements, internal controls, and quality standards
  • Drive effective change management to support adoption, sustainability, and realization of operational and business outcomes
  • Provide clear, concise executive-level communications and presentations regarding project status, risks, dependencies, deliverables, and realized value
  • Mentor and support Project Coordinators and Project Managers through coaching, project guidance, and operational leadership
  • Perform additional duties as assigned

Minimum Qualifications:

  • Bachelor’s degree from an accredited institution or equivalent work experience
  • HS Diploma or GED from an Accredited Institution

  • Prior experience leading medium-to-large-scale, clinically focused projects within healthcare or health insurance
  • Demonstrated experience delivering AI-enabled platforms, advanced analytics solutions or new software platforms solutions within healthcare operations
  • Experience managing enterprise software implementations with vendors, systems integrators, and internal IT teams
  • Experience requiring executive presence to influence decisions and drive alignment across senior leaders and diverse stakeholder groups
  • Demonstrated expertise managing projects with significant operational and technology dependencies requiring analytical, communication, and problem-solving skills
  • Experience applying project delivery methodologies, with proven ability to tailor approaches depending on goals/initiatives

Preferred Qualifications:

  • Master’s degree or advanced-level certification such as Project Management Professional (PMP), Program Management Professional (PgMP), Six Sigma, or Lean
  • Experience working in a Scaled Agile Framework (SAFe) environment
  • Knowledge and/or experience with multiple Agile techniques: User Stories, ATDD, TDD, Continuous Integration, Continuous Testing, Pair Programming, Automated Testing
  • Experience with application and/or systems implementations or upgrades

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLCshallnotdiscriminateagainstanydisabledemployeeorapplicantinregard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $122,900 - $188,020

  • All Other Locations (within approved locations): $105,100 - $160,480

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

Healthfirst

About Healthfirst

Healthfirst believes that every New Yorker deserves access to the best available healthcare. As one of New York’s highest quality not-for-profit health insurers serving close to two million New Yorkers, we make this a reality for our members. Founded more than 30 years ago by the leading hospital systems in downstate New York, Healthfirst established a partnership model that enables hospitals, health systems, and physicians in our network to prioritize health outcomes over profits, placing the needs of our members and community first. Healthfirst serves members in New York City, on Long Island, and in Westchester, Rockland, Sullivan, and Orange counties, offering market-leading products to suit every life stage. Our offerings include Medicaid plans, Medicare Advantage plans, Child Health Plus plans, Essential Plans, Long-Term Care plans, and Qualified Health plans. For more information on Healthfirst, please visit healthfirst.org.

Industry
Healthcare & Social Services
Company Size
5,001-10,000 employees
Headquarters
New York, NY
Year Founded
1993
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