(Senior Role) Clinical Governace Specialist
Core
Provide expert clinical insight and oversight to protect the clinical, ethical, reputational, and financial integrity of a healthcare scheme, acting as a strategic advisor to the CMO and CFO.
Role type
Senior Clinical Governance Specialist (Managed Care)
Builds
Clinical governance frameworks, procurement strategies, provider contracts, and SLA compliance reports
Domain
Healthcare / Managed Care / Clinical Governance
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Clinical data analysis, Contract & SLA interpretation, Commercial & financial acumen, Administrative independence, Evidence-based medicine evaluation, Health technology assessment
Preferred skills
Public health, Health economics, Healthcare management, Clinical governance, Medical audit
Technologies
None stated
Responsibilities
Support the Chief Medical Officer in executing clinical governance functions and strategic objectives; Monitor and evaluate clinical oversight for strategic risk management and value-based care programs; Review clinical and funding policies to ensure alignment with evidence-based medicine guidelines; Provide robust clinical analysis for healthcare service procurement and RFPs; Monitor external healthcare providers against Service Level Agreements (SLAs); Provide clinical expertise to the Product Development team for new benefits design
Seniority
Senior, hands-on IC
