Sr. Manager, Clinical Interventions

Alignment Health

11d•$98,550 - $147,825

About The Position

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Sr. Clinical Interventions Manager is responsible for designing, documenting, implementing, and continuously improving scalable clinical interventions that support quality, utilization, and population health objectives within a Medicare Advantage environment. This role serves as a bridge between clinical, operational, technical, and vendor partners, ensuring that internal and externally enabled interventions are operationally sound, technically feasible, and aligned to clinical and regulatory requirements. The Senior Manager plays a key role in evaluating vendor solutions, assessing operational and clinical fit, and supporting ongoing vendor performance management.

Requirements

5+ years of experience in Medicare Advantage, clinical operations, population health, healthcare consulting, or related fields.
Experience designing and implementing clinical or quality-related interventions.
Experience evaluating vendor solutions or supporting vendor-enabled programs.
Experience documenting workflows and translating business requirements for technical teams.
Familiarity with CMS STAR measures strongly preferred.
Master’s degree in Healthcare Administration, Public Health, or related field
Strong understanding of Medicare Advantage clinical and quality programs.
Ability to assess clinical, operational, and technical fit of vendor solutions.
Proven skills in workflow design, documentation, and process improvement.
Experience authoring business and functional requirements.
Strong change management and stakeholder engagement skills.
Analytical mindset with the ability to translate data into actionable improvements.
Excellent written and verbal communication skills.
The employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Nice To Haves

Clinical licensure (e.g., RN, NP, MD, DO).
Lean Six Sigma, other processes improvement certification, Certified Professional in Healthcare Quality (CPHQ), or Certified Professional in Healthcare Management (CPHM)

Responsibilities

Clinical Intervention Design Design end-to-end clinical interventions addressing quality, utilization, and population health priorities, including preventive care, chronic condition management, and medication adherence.
Translate CMS, STAR, and internal clinical requirements into actionable intervention models.
Define intervention goals, target populations, eligibility criteria, and success metrics.
Workflow Documentation & Process Design Develop detailed current-state and future-state workflow documentation for internal and vendor-supported interventions.
Document roles, responsibilities, handoffs, decision points, and exception handling.
Create standard operating procedures (SOPs), playbooks, and implementation documentation to support consistent execution.
Translation to Technical Requirements Partner with IT, product, analytics, and data teams to translate clinical workflows into technical and functional requirements.
Author business requirements for system configuration, data exchange, reporting, and automation.
Support user acceptance testing (UAT), implementation validation, and post-go-live issue resolution.
Vendor Evaluation & Operational Fit Assessment Support evaluation of clinical intervention vendors by assessing: Clinical appropriateness and evidence base Alignment to CMS and STAR requirements Operational workflow fit and scalability Technical integration requirements and data dependencies Partner with vendor management and clinical leaders to support ongoing vendor performance monitoring.
Define operational success metrics and workflow dependencies for vendor-enabled interventions.
Identify performance gaps and workflow friction impacting vendor outcomes and recommend improvements.
Change Management & Enablement Lead change management efforts for new and updated clinical interventions, including those delivered through vendor partnerships.
Develop training materials, job aids, and communication plans to support adoption by clinical and operational teams.
Facilitate stakeholder alignment across internal teams and external partners.
Performance Monitoring & Continuous Improvement Monitor intervention performance using defined KPIs, including gap closure rates, operational efficiency, and clinical outcomes.
Use performance data and frontline feedback to identify improvement opportunities.
Lead iterative enhancements to workflows, technical requirements, and vendor-enabled processes.
Cross-Functional Collaboration Collaborate with Quality, STAR, Care Management, Pharmacy, Network Management, Analytics, IT, and Vendor Management teams.
Serve as a key liaison between clinical operations, technical teams, and vendor partners.
Ensure interventions remain aligned with evolving regulatory, clinical, and operational requirements.