Position OverviewThis role is part of the Clinical Review leadership team responsible for operations, setting strategic direction and ensuring integration with broader organizational goals. Serves as a key decision-maker for compliance, quality, and innovation initiatives, influencing policy development and industry engagement.
What You'll Do:- Manage multiple teams or a large team with diverse technical responsibilities.
- Define long-term vision and strategic priorities for Clinical Review across the organization.
- Drive enterprise-wide initiatives to enhance compliance, quality assurance, and operational efficiency.
- Collaborate with executive leadership to align Clinical Review objectives with corporate strategy.
- Lead policy development and ensure adherence to national and international regulatory standards.
- Oversee large-scale audits, risk assessments, and accreditation processes.
- Represent the organization in external professional conferences, regulatory forums, and industry partnerships.
- Champion innovation by evaluating emerging technologies and integrating AI-driven solutions into review processes.
- Develop succession plans and leadership pipelines to sustain organizational growth and expertise.
- Provide training, support, and development opportunities to team members to ensure high performance and engagement.
- Conduct regular performance reviews, provide feedback, and identify opportunities for professional development.
What You'll Bring to Zelis: - Typically has Bach. +12 yrs.; Masters +8 yrs. Attends company training and regional training in area of expertise. Presents own work to members of department and external consultants and external professional conferences, Collaborates externally, Hosts external guests, visitors and consultants
- Requires proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents.
- Experience leading multiple teams or large-scale projects.
- Strong strategic thinking and execution capabilities.
- Ability to influence cross-functional stakeholders and drive alignment.
- Advanced leadership and coaching skills.
- Advanced knowledge of healthcare regulations, guidelines, and best practices related to clinical reviews.
- Certification in clinical review or a related field is preferred (e.g., Certified Professional in Healthcare Quality (CPHQ)).
- Strong financial and operational management skills.
- Ability to drive strategic initiatives and influence executive stakeholders.
- Strong leadership and team management skills, with the ability to motivate and inspire others.
Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.Location and Workplace FlexibilityZelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies.
While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.
