Manager Clinical Policies, Audit and Effectiveness

As a Senior Manager for Clinical Policies and Exceptional Cases with a focus either on Clinical Policies, Audit and Effectiveness or Prior Approval and Exceptional Cases, you lead the development, implementation, and oversight of clinical commissioning policies and individual funding request (IFR) processes across the ICB. You ensure that decisions are evidence-based, legally robust, and aligned with national guidance and local strategic priorities. Your role supports the effective and equitable use of NHS resources by managing clinical thresholds, reviewing exceptional cases, and enabling consistent, transparent decision-making across the system., Lead the development, review, and implementation of clinical commissioning policies, ensuring alignment with NICE guidance, national frameworks, and local priorities.Manage the end-to-end process for Individual Funding Requests (IFRs), including triage, clinical review, panel coordination, and decision documentation.Ensure all policy and case decisions are underpinned by clinical evidence, legal and ethical principles, and resource stewardship.Maintain robust governance frameworks for policy development and IFR decision-making, including audit trails, appeals processes, and reporting mechanisms.Collaborate with clinicians, commissioning teams, legal advisors, and public health colleagues to ensure policies are clinically sound and operationally feasible.Monitor and evaluate the impact of clinical policies on service utilisation, patient outcomes, and financial sustainability.Provide expert advice on clinical thresholds, treatment access criteria, and exceptional case handling to support commissioning and transformation programmes.Lead stakeholder engagement and consultation processes for policy updates and service changes.Ensure compliance with statutory duties, including equality impact assessments, legal challenge readiness, and public accountability.Represent the ICB in regional and national forums related to clinical policy, IFRs, and utilisation management.

• Educated to degree level or equivalent experience in a relevant field (e.g., health, care, public services, or management).
• Evidence of ongoing professional development and commitment to maintaining up-to-date knowledge and skills
• Significant experience in senior management within a complex organisation, ideally in health or public services
• Registered health care professional with evidence of up to date CPD
• Relevant professional qualification (where applicable)., Proven management experience in a multi-agency or complex environment
• Demonstrable success in delivering change, transformation, or service improvement programmes
• Understanding of health and care systems, policy context, and organisational priorities.
• Experience in strategic planning, commissioning, or service redesign to improve outcomes and efficiency.
• Ability to work effectively with a wide range of stakeholders and partners.
• Experience of operating in politically sensitive environments and managing competing priorities, Excellent communication and influencing skills, able to present complex information clearly to varied audiences
• Strong relationship-building and partnership-working skills across organisational boundaries.
• Analytical ability to interpret complex data and use insights to inform decisions
• Financial awareness and ability to ensure effective use of resources
• Skilled in managing complexity and ambiguity, making sound decisions under pressure, and maintaining focus on strategic goals.
  
  We are committed to promoting equal opportunities to achieve equity of access, experience and outcomes and to recognising and valuing people's differences. We are passionate about creating an inclusive workplace that promotes and values diversity; we see this as a strength and part of our founding mission, values and behaviours. We know through experience that different ideas, perspectives and backgrounds create a stronger and more creative work environment that delivers patient outcomes.