Senior Manager Clinical Policies, Audit and Effectiveness

Main area Utilisation Management - Prior Approval and Exceptional Cases Grade NHS AfC: Band 8a Contract Permanent Hours

• Full time
• Flexible working

Job ref 644-CE086

Employer Central East Integrated Care Board Employer type NHS Site Central East ICB Town Ely, Cambridgeshire Salary £57,528 - £64,750 per annum Salary period Yearly Closing 29/09/ :59

Senior Manager Clinical Policies, Audit and Effectiveness

NHS AfC: Band 8a

We are Central East ICB, the new organisationentrusted with serving more than 3.5 million people across Bedfordshire, Luton, Milton Keynes, Cambridgeshire and Peterborough and Hertfordshire.

We are responsible for making sure that the NHS can continue to support our community – now, and in the future. Everything we do will be guided by our core purpose: to do what best serves the population of this area.

We promise to focus on what makes the biggest difference to people’s lives – acting earlier to help prevent illness and detect disease and making it easier for our community to get the health care they need, closer to home, whenever that’s possible.

Job overview

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.

This role covers the areas of Cambridgeshire, Bedfordshire and Hertfordshire

Main duties of the job

• 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.

Working for our organisation

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.

We are committed to creating the best place to work, where your contribution is valued, your wellbeing is supported and all our colleagues can reach their full potential. We welcome and encourage applications from all areas of the community, who meet the criteria for the role, regardless of their protected characteristic. We work to ensure that our recruitment processes are as inclusive as possible to everyone, including making adjustments for people who have a disability or long-term condition and support with the recruitment process for people with lived experience.

We are happy to discuss flexible working options for all roles.

We operate a Carer friendly working environment that is supportive and inclusive. We actively encourage Carers to self-identify themselves.

We are a Disability Confident Employer and commit to shortlisting suitable applicants who meet the essential criteria for an interview. Please inform us of any adjustments you may require.

Detailed job description and main responsibilities

For further information on this role, please see the job description and person specification attached

Person specification

Qualifications

• 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).

Knowledge and Experience

• 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

Skills and Abilities

• 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.

Please Note:

• This vacancy may close before the advertised closing date if a sufficient number of suitable applications are received. We recommend submitting your application early to avoid disappointment.
• Successfully shortlisted applicants will be contacted by email with an invitation to interview.
• Please note that we do not pay interview expenses, all costs are incurred by the candidate.

Notes on completion of applications:

• All reference requests will be made to your employer/previous employers' HR Department, covering the previous 3 years of activity.
• We are committed to safeguarding and promoting the welfare of children, young people and vulnerable adults, and expect all staff to undertake this commitment. Applicants will be subject to robust safer recruitment processes.
• All eligible staff will need to have gained clearance through a standard/enhanced DBS check prior to working.
• All posts are subject to a probationary period.

Employer certification / accreditation badges

Name Jo Oliver Job title Senior Manager Prior Approval & Exceptional Cases Email address

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