New

Clinical Trial Project Manager

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Oct 14, 2025
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. 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. Working Conditions This is a remote role that can be done from most US states Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.