Director, Clinical Practice

Sagility; Philippines; On-site; PHP 2,500,000 - 4,200,000; Full time

Job summary

Sagility is seeking a Director, Clinical Practice to lead the clinical growth strategy across utilization management, care management, and front-/back-office services for payers, providers, and workers' compensation entities. This senior role functions as a clinical authority and strategic advisor throughout the opportunity lifecycle.

The incumbent will shape differentiated go-to-market propositions, partner with cross-functional leaders, and drive value through evidence-based recommendations,

Qualifications

• Bachelor's degree in nursing or related field; advanced degree preferred.
• Active, unrestricted clinical license relevant to role requirements.
• Typically 12+ years in managed care, medical management, or healthcare operations.

Responsibilities

• Shape Sagility's clinical growth strategy across UM, CM, and related services.
• Lead clinical components of complex RFPs, RFIs, and executive client engagements.
• Translate market needs into differentiated clinical solutions with measurable outcomes.
• Ensure clinical integrity, regulatory compliance, and scalable models across programs.

Skills

Executive presence

Strategic thinking

Data interpretation

Stakeholder management

Communication

Problem solving

Education

Bachelor's degree in nursing or related field

Active nursing license (USRN or equivalent)

Tools

Microsoft 365

Data analysis tools

UM/CM platforms

Job description

The Director, Clinical Practice is a senior individual contributor accountable for shaping and advancing Sagility's clinical growth strategy across utilization management, care management, and clinical front- and back-office services for healthcare payers, providers, and workers' compensation organizations. The role serves as a clinical subject-matter authority and strategic advisor across the opportunity lifecycle - from market sensing, solution design, pursuit strategy, and executive client engagement through implementation readiness, incubation, and operational handoff. The Director independently leads complex, high-value workstreams; influences cross-functional and global stakeholders without direct reporting authority; develops scalable, compliant clinical capabilities; and helps translate market needs into differentiated solutions that improve quality, experience, outcomes, productivity, and cost of care.

Key Duties and Responsibilities:

Clinical Growth and Commercial Leadership

• Own the clinical strategy and workplan for priority growth opportunities across utilization management, care management, population health, clinical review, and related front- and back-office services.
• Lead the clinical components of complex RFPs, RFIs, due-diligence discussions, solution workshops, and oral presentations; develop persuasive, evidence-based narratives, operating assumptions, and executive-level recommendations.
• Partner with sales, solutions, marketing, finance, legal, compliance, and delivery leaders to shape differentiated go-to-market propositions, campaigns, account-growth plans, and pursuit strategies.
• Engage senior client and prospect stakeholders as a trusted clinical advisor, clarifying business needs, challenging assumptions constructively, and connecting Sagility capabilities to measurable clinical and financial outcomes.
• Identify whitespace opportunities within existing accounts and emerging segments; develop business cases, value propositions, and roadmap recommendations that support sustainable revenue growth.

Clinical Solution Design and Innovation

• Architect scalable clinical operating models, workflows, governance structures, staffing approaches, quality controls, and performance frameworks aligned with client requirements and Sagility delivery capabilities.
• Translate regulatory, accreditation, market, and technology trends into practical solution requirements, including automation, analytics, interoperability, digital engagement, and AI-enabled clinical workflow opportunities.
• Define clinical requirements, guardrails, decision criteria, and success measures for new capabilities; evaluate feasibility, clinical integrity, member impact, operational risk, and return on investment.
• Create and maintain reusable solution assets, playbooks, clinical process standards, case studies, presentation materials, and intellectual property that improve consistency and speed-to-market.
• Provide expert clinical review of solution designs, statements of work, performance commitments, and transition plans to ensure assumptions are achievable, compliant, and operationally sound.

Transition, Incubation, and Operational Readiness

• Serve as the senior clinical lead for new-program transitions and expansions, establishing clinical readiness criteria across process design, workforce qualifications, curriculum, systems, documentation, quality, compliance, and reporting.
• Guide clinical talent strategies and vendor relationships, including role profiles, licensure and credential requirements, sourcing channels, competency standards, rate considerations, and quality expectations.
• Lead clinical risk and dependency reviews; identify gaps early, define mitigation plans, and elevate material concerns with clear options and recommendations.
• Incubate complex or first-of-kind clinical programs, monitor early performance, and stabilize delivery against service-level, quality, productivity, turnaround-time, and outcome commitments before structured handoff to operations.
• Develop handoff criteria, governance routines, and knowledge-transfer plans that ensure continuity, accountability, and sustained performance after transition.

Clinical Governance, Quality, and Compliance

• Embed applicable federal and state requirements, HIPAA expectations, client policies, accreditation standards, and evidence-based clinical practices into solution and operating-model design.
• Partner with quality, compliance, privacy, security, legal, and operational stakeholders to evaluate clinical risk, resolve control gaps, and support audit and client-review readiness.
• Define meaningful clinical, operational, experience, and financial measures; interpret performance data and recommend corrective or preventive actions based on root-cause analysis.
• Promote high standards of clinical documentation, decision consistency, member safety, ethical practice, and scope-of-practice adherence across proposed and incubated services.

Thought Leadership and Enterprise Influence

• Monitor competitor offerings, buyer priorities, reimbursement and regulatory developments, workforce trends, and emerging care-delivery models; convert insights into actionable recommendations for Sagility leadership.
• Author and present thought-leadership content, executive briefings, market perspectives, and client education materials that strengthen Sagility's clinical brand and credibility.
• Facilitate cross-functional decision-making across global teams, building alignment among stakeholders with competing priorities while maintaining momentum and accountability.
• Coach and mentor project teams, solution contributors, and clinical SMEs through influence and expertise; establish standards and review work products without direct people-management responsibility.
• Represent Clinical Practice in enterprise initiatives and governance forums, advocating for member-centered design, clinical quality, responsible innovation, and operational scalability.

Decision-Making Scope and Accountability

• Operates with substantial autonomy and is accountable for the quality, clinical integrity, timeliness, and executive readiness of assigned growth, solution, and transition deliverables.
• Makes recommendations that may materially influence pursuit strategy, solution scope, staffing models, implementation risk, client commitments, and investment priorities.
• Leads through influence in a matrixed environment and may direct workstreams, work products, and deliverables without having direct reports.
• Escalates decisions involving material clinical, compliance, contractual, financial, or reputational risk through the appropriate governance channels.

Qualifications and Experience

• Bachelor's degree in nursing USRN or another relevant clinical discipline required; advanced degree in nursing, healthcare administration, public health, business, or a related field preferred.
• Active, unrestricted professional clinical license, where applicable to the candidate's discipline and role requirements; nursing licensure is strongly preferred.
• Typically, 12 or more years of progressive experience in managed care, medical management, healthcare operations, clinical consulting, or related services, including significant experience in utilization management and/or care management.
• Demonstrated success leading complex clinical solution design, RFPs, executive client engagements, transitions, program launches, or transformation initiatives in a matrixed environment.
• Strong knowledge of healthcare payer and provider operations, federal and state regulatory expectations, HIPAA, and relevant accreditation and quality standards, including NCQA-related requirements.
• Experience developing business cases, performance models, operating assumptions, clinical governance structures, and measurable value propositions.
• Proficiency with Microsoft 365, data analysis and visualization, presentation development, and common UM/CM platforms or healthcare workflow technologies.
• Experience supporting global delivery, outsourced services, or business process operations is preferred.

Skills and Competencies

• Executive presence and exceptional written, verbal, facilitation, and presentation skills; able to communicate complex clinical and operational concepts clearly to diverse audiences.
• Advanced strategic thinking, structured problem-solving, data interpretation, business acumen, and sound clinical judgment.
• Ability to synthesize ambiguous inputs, establish direction, prioritize high-impact work, and deliver polished outputs under tight timelines.
• Strong stakeholder management, consultation, negotiation, conflict-resolution, and influencing skills across senior, interdisciplinary, and global teams.
• Highly self-directed, organized, adaptable, and accountable, with the ability to manage multiple complex initiatives in a high-volume environment.
• Resourceful, diplomatic, commercially aware, and committed to member-centered, ethical, compliant, and evidence-based clinical practice.