Clinical Initiatives Manager Who We Are: TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver optimal care. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people nationwide across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system. Position Summary The Clinical Initiatives Manager is an individual contributor role responsible for planning, coordinating, and executing strategic clinical initiatives that support quality improvement, care management effectiveness, regulatory compliance, and population health outcomes. This role partners closely with clinical leadership, operations, quality, analytics, IT, and compliance teams to implement programs that enhance clinical performance, improve patient outcomes, and align with organizational goals. The Clinical Initiatives Manager provides leadership, coordination, and communication across cross-functional teams to ensure clinical initiatives are implemented effectively, measured for impact, and sustained through evidence-based practices and regulatory alignment. Essential Duties and Responsibilities: Clinical Initiative Planning and Implementation - Lead the planning and execution of clinical initiatives focused on improving care delivery, quality outcomes, utilization management performance, and population health strategies.
- Develop initiative charters, implementation plans, timelines, milestones, and measurable outcomes.
- Coordinate implementation of clinical programs, including workflow improvements, care management enhancements, and quality improvement interventions.
- Ensure initiatives are delivered on time, within scope, and aligned with organizational clinical strategy and regulatory expectations.
Stakeholder and Cross-Functional Collaboration - Serve as a key liaison between clinical leadership, care management teams, utilization management, operations, quality, analytics, and IT.
- Facilitate working groups, initiative planning sessions, and regular progress reviews with stakeholders.
- Communicate initiative progress, risks, and outcomes to leadership and operational teams.
- Support alignment across departments to ensure successful adoption of clinical initiatives.
Clinical Quality and Regulatory Alignment - Ensure initiatives align with regulatory requirements, accreditation standards, and payer expectations, including Medicare, Medicaid, and commercial guidelines.
- Support initiatives related to clinical quality metrics, care coordination, medical necessity review processes, and population health management.
- Assist with readiness for regulatory audits, accreditation reviews (e.g., NCQA, CMS), and internal quality assessments.
- Collaborate with quality and compliance teams to support clinical performance improvement programs.
Process Improvement and Clinical Workflow Optimization - Evaluate current clinical workflows and operational processes to identify opportunities for efficiency, quality improvement, and compliance.
- Partner with subject matter experts to design and implement improved clinical processes and care pathways.
- Develop and maintain documentation including workflows, standard operating procedures (SOPs), and implementation guides.
- Promote best practices and standardization across clinical programs.
Data Analysis, Reporting, and Performance Monitoring - Track initiative progress using defined performance metrics and key performance indicators (KPIs).
- Monitor post-implementation outcomes to ensure clinical initiatives achieve targeted improvements in quality, utilization, and patient outcomes.
- Collaborate with analytics teams to analyze performance data and identify improvement opportunities.
- Provide leadership with data-driven insights and recommendations to guide clinical strategy.
Additional Responsibilities - Support change management efforts and training coordination related to clinical initiative implementation.
- Promote adoption of evidence-based practices and continuous improvement methodologies.
- Contribute to strategic planning related to clinical program development and population health initiatives.
- Perform other duties as assigned.
Knowledge, Skills, and Abilities: - Strong understanding of healthcare delivery systems, care management workflows, and clinical quality improvement.
- Knowledge of regulatory and accreditation requirements (e.g., CMS, NCQA).
- Excellent organizational, analytical, and problem-solving skills.
- Ability to manage multiple initiatives in a fast-paced healthcare environment.
- Strong written and verbal communication skills, including executive-level reporting.
- Ability to influence cross-functional teams and build consensus across clinical and operational stakeholders.
- Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook); experience with project management or analytics tools preferred.
TurningPoint Healthcare Solutions is an Equal Opportunity Employer.
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