Senior Manager - Healthcare Compliance, Clinical Strategy & Healthcare Quality Innovation

Req ID: Req_00184961_US

Location: United States, NV, United States

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Description

Sr Manager - Healthcare Compliance, Clinical Strategy & Healthcare Quality Innovation

TELUS Digital - Healthcare Vertical

Location

United States (Global Oversight across U.S., India, Philippines, LATAM)

Role Purpose

TELUS Digital is seeking a senior healthcare administrator to establish and scale healthcare capabilities across compliance, clinical services, healthcare quality transformation, and member experience outcomes.

This role extends beyond traditional compliance administration and serves as a strategic administrator responsible for building TELUS Digital's healthcare governance model, while also assisting the healthcare team in developing clinically enabled outsourcing capabilities, and advancing healthcare quality and experience programs aligned to measurable payer outcomes.

The role will partner directly with healthcare leadership to strengthen TELUS Digital's healthcare market position while ensuring operational and regulatory excellence.

Strategic Responsibilities

1. Build TELUS Digital Healthcare Governance & Compliance Strategy

Lead development and execution of an enterprise healthcare governance framework supporting:

• Medicare Advantage (Part C)

• Medicare Part D

• Medicaid

• Commercial health plans

• PBM and specialty pharmacy

• Clinically enabled operations

Responsibilities include:

• Establish healthcare compliance operating model

• Build CMS, HIPAA, FWA, and audit readiness framework

• Develop healthcare policies and governance standards

• Lead healthcare audit and remediation activities

• Govern healthcare compliance requirements across MSAs and SOWs

• Establish enterprise healthcare risk monitoring

Serve healthcare compliance administrators with authority supporting growth and risk management.

1. Build TELUS Digital Clinical Outsourcing Strategy

Assist the Healthcare vertical leader in designing and establishing clinically enabled outsourcing capabilities that expand TELUS Digital's healthcare service portfolio.

Strategic focus areas include:

• Nurse-based service delivery models

• Clinical support operations

• Pharmacist-enabled support solutions

• Care coordination and navigation

• Medication adherence programs

• Wellness and chronic condition engagement

• Utilization and quality support

• Transitions of care

Partners with Operations and Solutions teams to define scalable delivery approaches.

1. Healthcare Quality, Experience & Outcomes Innovation

(CAHPS, HEDIS & STARS)

Partner with Healthcare Leadership, Quality, Digital, and Operations teams to identify measurable gaps across healthcare quality and member experience performance.

• CAHPS performance measures

• HEDIS outcomes

• Medicare STARS performance

• Member engagement

• Complaint reduction (CTM)

• Medication adherence

• Provider and member satisfaction

• Access and service experience

Leverage TELUS Digital capabilities including:

• CX transformation

• Digital engagement

• AI-enabled workflows

• Omnichannel experience design

• Analytics and insight generation

Translate healthcare quality opportunities into scalable operational capabilities for payer and PBM environments.

1. Healthcare AI Governance & Regulatory Alignment

Lead governance and operational oversight for AI-enabled healthcare services.

Responsibilities include:

• AI governance controls

• Healthcare AI operating standards

• HIPAA and CMS alignment

• Human oversight requirements

• Healthcare automation governance

• AI risk monitoring

Ensure digital healthcare innovation remains compliant and operationally sound.

Qualifications

Required

• 5-8 years healthcare leadership/Administration experience

• Deep experience across:

• Medicare Advantage

• Medicaid

• Healthcare compliance

• STARS / HEDIS / CAHPS

• Quality improvement

• Healthcare operations

• Experience supporting offshore/global delivery environments

• Experience working with payer, PBM, provider, or healthcare BPO organizations

• Executive communication capability

Strongly Preferred

• Clinical licensure (RN, LPN, Pharmacist, or equivalent)

• Experience leading healthcare quality initiatives

• Experience supporting healthcare audits and delegation oversight

• Experience with healthcare CX and digital transformation

• Experience with training and workforce enablement programs

Success Measures

Year 1 Outcomes

• Launch TELUS Digital Healthcare Governance Program

• Establish audit-ready healthcare compliance framework

• Define clinically enabled outsourcing capabilities

• Build measurable quality initiatives tied to CAHPS, HEDIS, and STARS

• Improve healthcare risk posture and audit readiness

• Strengthening TELUS Digital's healthcare differentiation through measurable outcomes

Why This Role Matters

This role represents a foundational investment in TELUS Digital's healthcare growth strategy.

Success will position TELUS Digital as a differentiated healthcare services partner, combining healthcare governance, clinical capability, quality improvement, and member experience transformation to improve measurable outcomes across payer and healthcare ecosystems.

About Company:

TELUS Digital is the customer experience transformation partner to the world's most admired brands. Our diverse team weaves data, technology, and human ingenuity to deliver differentiated customer journeys, drive operational effectiveness, and scale AI solutions with meaningful value and positive impact.

We craft real-world solutions in the moments that matter, from customer acquisition to lifelong loyalty. Enabled by our global reach - spanning 78,000 experts in 33 countries - and deep industry expertise, we help over 600 organizations make the customer experience feel effortless.

Our solutions span Data & AI, Digital Experience & IT, CX Management and Trust & Safety. At the core of our innovation is Fuel iX, an enterprise-grade generative AI platform that helps clients safely access and optimize leading LLMs to scale their own AI from pilot to production.

Equal Opportunity Employer Statement

At TELUS Digital, we are proud to be an equal opportunity employer and are committed to creating a diverse and inclusive workplace. All aspects of employment, including the decision to hire and promote, are based on applicant's qualifications, merits, competence and performance without regard to any characteristic related to diversity.

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