CLINICAL PROGRAM MANAGER JOB DESCRIPTION

A Clinical Program Manager carries accountability for that entire execution layer: owning study-level timelines, vendor governance, budget forecasting, and cross-functional coordination from protocol setup through database lock. Scope spans both pharmaceutical and Class III medical device pipelines, operating within ICH guidelines and applicable FDA regulatory frameworks.

As the Clinical Program Manager, you direct the operational execution of complex global clinical studies, translating protocol requirements into study management plans that keep trials on schedule, within budget, and audit-ready. You work across a matrix of internal clinical leadership, CROs, core labs, and regulatory affairs, with accountability that extends from investigational site performance to executive-level status reporting.

Career Impact: Owning full-cycle execution of Phase I–III trials or IDE/PMA studies positions you as a senior operational authority in one of the most credential-intensive niches in clinical development.

Business Impact: The programs you manage are the direct pipeline to regulatory submission - enrollment delays or quality deviations you prevent translate directly into protected development timelines for marketed products.

Growth Opportunity: Experience managing global, multi-vendor trial portfolios - with exposure to both pharmaceutical and Class III device regulatory pathways - is a recognized stepping stone to Associate Director or VP of Clinical Operations roles.

• Lead cross-functional study execution teams, ensuring goals, risks, and action items are tracked to resolution across all trial phases.
• Develop and manage study-level timelines, rolling forecasts, and trial budgets to keep programs on schedule and within approved spend.
• Oversee CRO and core lab performance against contractual deliverables, initiating mitigations when quality, timeline, or budget variances arise.
• Ensure clinical trial conduct adheres to GCP/ICH guidelines, applicable FDA regulations, and ISO standards throughout study execution.
• Maintain trial master file readiness and lead audit and inspection preparedness, including management-level representation during regulatory reviews.
• Collaborate with Regulatory Affairs to prepare clinical summaries supporting IDE, 510(k), PMA, and related submissions.
• Develop and maintain key study documents - including protocols, amendments, informed consent forms, and clinical study reports - to meet submission standards.
• Monitor site enrollment, adverse event trends, and field safety reporting, developing corrective action plans for non-compliance issues.

• Bachelor's degree in life sciences, nursing, biomedical engineering, or a related scientific or medical field, or equivalent work experience.
• Seven or more years of clinical research experience, including hands-on management of global or multi-site clinical trials in pharmaceutical or medical device settings.
• Demonstrated knowledge of GCP/ICH guidelines and their application to Phase I–III drug trials or Class II/III device studies.
• Experience managing CROs, core laboratories, and other clinical vendors, including budget negotiation and performance oversight.
• Proven ability to develop and manage study budgets, rolling forecasts, and resource plans across complex, cross-functional programs.
• Demonstrated capability leading matrix teams - including clinical operations, regulatory affairs, and medical - without direct line authority.
• Strong working knowledge of FDA regulatory submission processes, including IDE or 510(k) pathways or IND-related filings.
• Excellent written and oral communication skills, with demonstrated experience presenting study status to executive and cross-functional leadership.

• Advanced degree (Master's or PhD) in a life sciences or biomedical discipline, or PMP certification.
• Direct experience with Pre- and Post-Market clinical strategies for Class III devices, including IDE study design and execution.
• Specialist therapeutic area knowledge in oncology, immunology, cardiology, or a related high-complexity indication.
• Prior CRO-side experience or international and intercultural trial execution experience across multiple regulatory jurisdictions.

• Protocol deviation rate per 100 patient visits, tracking how well site conduct is maintained against the approved protocol.
• TMF completeness score at interim audit milestones, measuring readiness against regulatory inspection standards.
• Study milestone variance in days, capturing how closely execution tracks against approved project timelines.
• Budget forecast accuracy as a percentage variance from approved study spend at each rolling forecast cycle.
• Site activation cycle time in days, reflecting how efficiently new investigational sites are brought to first-patient-in readiness.
• Typical tools: Clinical trial management systems (commonly Veeva Vault CTMS or Medidata Rave); project scheduling software (commonly MS Project or similar)

• Base Salary Range: $110,000–$155,000 annually, varying by seniority and device vs. pharma sector
• Bonus: 10–15% annual target bonus tied to study milestones and individual performance
• Equity: Stock options or RSUs common at biotech and medical device companies; less standard at large pharma
• Health Benefits: Medical, dental, and vision coverage; FSA or HSA options typically included
• PTO: 15–20 days annually, plus federal holidays and sick leave
• Common Perks: Remote or hybrid work flexibility, conference and professional development funding, clinical certification reimbursement

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

The Clinical Program Manager owns full-cycle clinical project management for global studies, leading the cross-functional study execution team and coordinating vendor selection, TMF oversight, and study-level timelines. Reporting to senior leadership, this role delivers direct impact on clinical program quality and regulatory compliance across the pharmaceutical development process.

Key Responsibilities

• Plan, manage, and execute clinical programs.
• Create and drive study-level timelines.
• Develop and manage study budgets.
• Provide input on operational aspects of the protocol.
• Ensure regulatory and GCP compliance.
• Oversee TMF with periodic audits.
• Lead vendor selection and management, including issue escalation.
• Develop and implement Study Management plans and all associated documents.
• Collaborate with internal team to plan and coordinate IMP and non-IMP supplies.
• Plan, lead, and facilitate SET meetings.
• Facilitate and coordinate communications with external providers.
• Ensure clinical operations team and external provider receive study-specific training.
• Report key study-performance information.
• Provide operational input into the overall program strategy.
• Act as primary point of contact for internal groups.
• Verify standard processes, tools, and procedures are used consistently for study execution.

Education & Experience

• Bachelor's degree in life science, nursing, pharmacy, medical laboratory technology, or a health-related area required.
• Postgraduate qualifications preferred.
• Other degrees and certifications considered if commensurate with related clinical research experience.
• Minimum of 6 years of relevant clinical research experience within the pharmaceutical industry required.
• Strong understanding of the drug development process and each step within the clinical trial process.
• Experience in overseeing global clinical trials required.
• Budget forecasting and management experience required.
• Experience in scientific or medical research preferred.
• Detailed knowledge of ICH guidelines and GCP and their application to all stages of the clinical development process.
• Knowledge of the therapeutic area and product candidates, clinical practice, competitors, and regulatory considerations.
• Specialist knowledge in immunology, coagulation disorders, pulmonology, virology, oncology, or cardiology preferred.
• Proficient in MS Project.
• Excellent interpersonal and decision-making skills.
• Strong project management skills.
• Excellent written and oral communication, planning, and time management skills.
• Ability to plan and ensure execution of clinical programs to the highest ethical and scientific standards.

Embedded within the Digest Health Leadership Team, the Clinical Program Manager integrates systems and resources across service lines to advance program development, clinical operations, and quality outcomes for digestive health services. Working closely with Physician Program and Administrative Leaders, this role ensures superior care delivery and competitive service offerings aligned with system goals.

Core Functions

• Drive program development and partner with medical leadership to design, develop, and implement clinically and fiscally responsive program philosophies, goals, standards, processes, and objectives.
• Ensure desired clinical services are rendered through timely, coordinated, multidisciplinary, cost-effective, and efficient processes.
• Promote Digestive Health Services to all customers by interpreting and communicating the system's mission and values.
• Act as a liaison to referring providers and collaborate with partners to grow market share.
• Provide vision and leadership to Digestive Health service line staff in a collaborative environment that fosters job satisfaction, recognition, and innovative thinking.
• Develop and manage center quality and outcomes data, analytics reporting, dashboards, and auditing tools to ensure delivery of cost-effective, quality care.
• Provide leadership and training to Digestive Health Nurse Navigators in partnership with Practice Managers, Providers, and Regional Operations Directors.

Required Qualifications

• 3–5 years of clinical practice experience required.
• 2–3 years of leadership or management experience required.
• Demonstrated ability to direct a diverse workforce in a busy ambulatory care environment.
• Demonstrated ability to manage multiple priorities.
• Knowledgeable in budgeting and financing of clinical programs, both salaried and non-salaried.
• Knowledgeable in Quality Improvement processes and capable of implementing related concepts.
• Demonstrated ability to implement and support change.
• Proficient in the operation and use of computer-based information systems to facilitate all aspects of care delivery.
• Excellent communication skills.

Reporting to the Program Director, the Clinical Program Manager leads direct care worker supervision, ensures safe and effective service delivery to participants with ASD and developmental disabilities, and maintains compliance with agency policies and service agreements. Partnering with clinical and administrative staff, this role supports proper staffing, training, and therapeutic planning to achieve program quality standards.

Primary Duties

• Supervise and direct a team of direct care workers ensuring safe and effective services are rendered.
• Provide direction to direct care workers to deliver services to participants according to service agreements.
• Review monthly direct care worker productivity data.
• Review direct care worker daily progress documentation and ensure accuracy in accordance with agency policies and procedures.
• Provide guidance on required training and information on appropriate documentation practices.
• Provide monthly direct and indirect supervision of direct care workers and maintain a log documenting direct supervision.
• Provide on-site supervision as per agency policy and as needed to determine staff competency and compatibility with clients.
• Conduct timely performance evaluations of direct care workers in accordance with agency policy.
• Monitor direct care worker absences, replacements, and overtime.
• Liaise regularly with participants and family members as required.
• Participate in planning and regular review of therapeutic activities and treatment plans.
• Collaborate with Program Director to ensure proper staffing with qualified and competent personnel.

Education & Experience

• Master's or PhD degree from an accredited college or university in special education or a related human services field required.
• At least 3 years of relevant experience in counseling or supervision required.
• Two to five years of experience in training and consultation in Autism Spectrum Disorder or other developmental disabilities required.
• At least one year of experience or training in providing services to children with ASD or other developmental disabilities required.
• Supervisory and management experience required.
• Experience providing staff development training required.
• Must be organized, creative, and efficient in overseeing, delegating, and managing multiple activities.
• Must be computer literate and possess budgeting and quality improvement coordination skills.
• Excellent oral and written communication skills.
• Excellent customer service skills, including the ability to work with families.
• Ability to work under deadline pressure, both independently and as part of a team.
• Attention to detail required.

Sitting at the intersection of clinical operations and program strategy, the Clinical Program Manager shapes the planning, setup, and closure of complex global clinical trials from phase I through phase III, including budgets, forecasts, and vendor performance. Operating across cross-functional matrix teams, this role ensures protocol adherence, risk mitigation, and contractual compliance to advance the clinical development pipeline.

Duties

• Provide strategic operational input into the Clinical Development Plan with respect to operational aspects and requirements, including definition of timelines, milestones, and resource needs.
• Steer and oversee the planning, setup, conduct, and closure of assigned projects and clinical trials, including trial budgets, rolling forecasts, and timelines.
• Oversee adherence to Clinical Trial Protocols and applicable guidelines, laws, regulations, and contractual agreements with assigned vendors.
• Analyze and evaluate the impact of anticipated, new, and updated project risks for clinical trials.
• Review and assess performance in quality, timelines, and budget of vendors and proactively initiate mitigations and improvements.

Qualifications & Experience

• MSc, preferably in life or natural sciences.
• PMP certification is a plus.
• 10+ years of related experience in a pharmaceutical company, biotech firm, or CRO, including at least 8 years of operational and managerial experience in planning, startup, and execution of clinical trials.
• Specific CRO experience is a plus.
• International and intercultural working experience in Clinical Development.
• In-depth knowledge of Clinical Development from phase I to phase III.
• Proven ability to work independently and lead multidisciplinary trial teams in a complex matrix environment.
• Proven experience in developing effective relationships with vendors, including budget negotiations and contracting.

A key member of the nursing and clinical operations team, the Clinical Program Manager builds and maintains departmental standard operating procedures, coordinates performance improvement activities, and establishes short- and long-term goals for nursing care delivery. Collaborating across departments and services, this role ensures all clinical initiatives align with institutional policies, regulatory requirements, and quality assessment standards.

Functions

• Ensure all clinical initiatives run according to institutional and departmental policies and in accordance with applicable government or regulatory requirements.
• Plan, develop, and maintain departmental standard operating procedures.
• Regularly review policies and procedures and recommend changes to superiors as necessary.
• Coordinate educational and performance improvement activities within a designated clinical specialty.
• Develop and design action plans to support clinical performance and competency.
• Provide support and educational resources to departments and services relative to nursing care delivery within quality assessment and improvement processes.
• Establish and implement short- and long-term goals, objectives, policies, and operating procedures for high-level performance in nursing care delivery.

Minimum Qualifications

• Bachelor's degree in Nursing required.
• Master's degree in Nursing or a health-related field preferred.
• Certification in specialty area (CPHQ) preferred.
• NYS Registered Nurse license required.
• 3+ years of related work experience required.
• Solid assessment, clinical, and documentation skills.
• Proficient in Microsoft Office Suite.
• Great interpersonal skills.
• Excellent written and verbal communication skills.
• Strong attention to detail.
• Highly organized, patient oriented.

Consistent delivery of enterprise clinical program outcomes depends on the Clinical Program Manager, who oversees multi-initiative implementation, vendor relationship management, and KPI monitoring across operational and financial performance domains. Based within a matrixed healthcare organization, this role supports the Clinical Program Director in solving complex pre- and post-deployment barriers while maintaining cross-functional stakeholder alignment.

Accountabilities

• Implement initiatives with a variety of approaches and requirements in partnership with internal and external stakeholders.
• Project manage multiple initiatives by defining scope, risk identification, project methodology, resource allocation, cost-benefit analysis, and process flows.
• Maintain relationships across teams to ensure effective support, feedback loops, and delivery of deliverables.
• Collaborate with appropriate individuals to provide required documents for committee and governance meetings.
• Assist in problem solving to help move implementation forward.
• Assist Clinical Program Director and Designer in solving complex operational and financial performance barriers pre-implementation and post-deployment.
• Support team in overseeing clinical vendor relationships and ongoing management of program operations.
• Gather requirements from business partners and provide documentation and solutions to address operational and technical needs.
• Develop and maintain strong relationships with internal teams and external vendors.
• Monitor Key Performance Indicators for specific clinical programs to define timelines and documentation necessary for financial compliance and performance.
• Evaluate data from analytic teams to correlate expected affordability results to the operational reality of the program.
• Conduct operational team reviews to determine FTE needs and costs.
• Create high-quality PowerPoint presentations.
• Provide regular updates regarding the implementation process and post-deployment monitoring.

Skills & Qualifications

• Undergraduate degree required.
• 3+ years of experience working in a healthcare setting, preferably in a managed healthcare company.
• 3+ years of project management experience including tracking, planning projects, working with large data sets, and making data-driven analytical decisions.
• Ability to navigate lines of business to deploy programs.
• Ability to read and interpret technical specifications and data validation reports to guide technical teams.
• Advanced proficiency in MS Office Suite including Word, PowerPoint, and Excel.
• Advanced proficiency in MS Excel using formulas and pivot tables to manipulate data and conduct data analysis.
• Excellent written and verbal communication skills and strong data presentation skills.
• Ability to multitask and work independently in a fast-paced, highly matrixed environment.
• Problem-solving skills, including the ability to systematically analyze complex problems and successfully devise and implement solutions.
• Ability to communicate with clinical operational teams, business teams, and IT to bridge the gap between stakeholders.

As the Senior Clinical Program Manager, this role leads full-cycle execution of complex global clinical studies for Class III devices, overseeing vendor management, study documentation, regulatory submissions, and enrollment of high-risk patients in accordance with GCP/ICH guidelines. The Clinical Operations team relies on this work to maintain audit-ready programs, deliver Study Status Reports to executive leadership, and advance IDE and PMA regulatory filings.

Strategic Responsibilities

• Facilitate and manage the strategy and execution of a highly complex study for a Class III device in collaboration with senior clinical and medical leadership.
• Lead core team meetings for assigned studies ensuring goals and deliverables are clearly defined and issues, decisions, risks, and actions are appropriately tracked.
• Manage enrollment of high-risk patients in a fast-paced environment.
• Oversee project development, performance tracking, and risk management associated with study management and clinical monitoring visit and report compliance.
• Manage project-specific vendors, including study committees, CRO, core labs, and DSMB.
• Provide regular Study Status Reports to cross-functional and executive leadership teams.
• Provide leadership and program representation to internal and external stakeholders, clinical sites, and healthcare providers.
• Develop key study documents including study protocols, amendments, study plans, procedure manuals, training materials, Informed Consent Forms, and Clinical Study Reports.
• Ensure conduct of clinical research programs in accordance with approved project plan, budgets, SOPs, and applicable regulations.
• Develop action plans for investigational sites, vendor management, non-compliance, and administrative issues.
• Plan, prepare, and present at Investigator and Research Coordinator Meetings as applicable.
• Provide Quality Assurance support including management-level representation during audits and inspections.
• Collaborate with Regulatory Affairs to prepare clinical summaries for IDEs, 510(k)s, PMAs, and related regulatory filings.

Experience & Qualifications

• Bachelor of Science degree in Science, Engineering, or a directly applicable medical or scientific field required.
• Direct experience successfully conducting 510(k) and IDE studies, including Pre- and Post-Market Clinical strategies required.
• Experience in Class III devices required.
• 7–10 years of clinical research experience, including global and international experience required.
• 3–5 years of medical device clinical research experience preferred.
• Expertise in Good Clinical Practice and regulatory compliance guidelines for clinical trials required.
• Maintain knowledge of competitive technologies and medical, technical, and biomedical developments related to relevant products.
• Polished communication and presentation style.
• High attention to detail and accuracy.
• Excellent prioritization and organizational skills.
• Advanced, metric-driven project management skills.
• Excellent interpersonal communication skills.
• Ability to work effectively on cross-functional teams.
• Positive, self-starter attitude with willingness to work in a fast-paced environment.

Clinical Program Manager delivers oversight of multiple simultaneous clinical studies across a medical device program, directing clinical team members, managing audit readiness, and evaluating clinical data for summary reports and regulatory submissions. The work directly supports cross-functional project development by ensuring monitoring compliance, device distribution control, and corrective action implementation across all active clinical projects.

Key Deliverables

• Determine applicable program or study objectives, strategy, scope, and schedule to meet business needs.
• Develop the project plan in consultation with the cross-functional program or project team, project stakeholders, and the clinical team.
• Present project plans, provide ongoing updates, and present project results to senior clinical management.
• Manage and oversee the execution of clinical programs involving multiple clinical studies.
• Ensure staff are trained on the requirements of the clinical project and the project plan.
• Manage and direct clinical team members working on the clinical program.
• Motivate and develop staff.
• Ensure the clinical project is audit-ready at all times, including team training records, central files, and system validation.
• Ensure adequate monitoring is conducted on all clinical projects.
• Conduct clinical visits to support clinical projects.
• Provide oversight to ensure safety concerns, adverse events, and trends in Field Events Reporting are identified and appropriate responses are developed and executed.
• Control device distribution and allocation.
• Monitor project reports for accuracy and trending.
• Provide input to project budgets and project plans.
• Provide clinical scientific support to project teams.
• Evaluate clinical data in preparation of study summary reports for presentations, publications, and submissions.
• Develop and implement corrective actions to address any noncompliance issues.
• Communicate with and provide updates to specific core teams.

Background & Experience

• Bachelor's degree in Engineering, Science, or a related field required.
• Advanced degree (Master's or PhD) is an asset.
• Minimum of 10 years of managing projects and working with clinical professionals within a team and in a cross-functional project development setting required.
• Minimum of 7 years of directly supporting clinical research or similar experience in a medical or scientific area required.
• Expertise with GCPs and regulatory compliance for clinical trials, including applicable ISO Standards and FDA requirements.
• Proficient knowledge of medical terminology.
• High attention to detail and accuracy.
• Advanced written and oral communication skills.
• Strong problem-solving skills.
• Ability to manage multiple tasks and priorities.

The Clinical Program Manager produces executive-level reporting, manages ACO VP communications, and leads ad hoc projects spanning Clinical, Network Contracting, and Healthcare Economics teams within a population health management program. Reporting to senior leadership and working across national and regional teams, this role advances shared savings and shared risk arrangements by driving goal-setting, issue tracking, and programmatic reporting to the national PMO.

Day-to-Day Responsibilities

• Help develop and support Line of Business ACO VP communications including MBO goals, key performance metrics and indicators, regional and market-specific ACO engagement activities, issues, risks, and best practices for monthly and quarterly business presentations and report outs.
• Manage internal LOB team cadence by assisting VPs with development of meeting agendas, notes, and follow-up action items.
• Help develop and implement standard senior executive and market CEO level reports.
• Manage the annual planning and goal-setting process with core team of national leaders across Clinical, Network Contracting, and Healthcare Economics teams and market leadership.
• Provide programmatic and tactical implementation support, including setting and measuring objective success metrics and tracking team issues, risks, and best practice activities.
• Lead medium to ad hoc projects with development of project charters, scope and operational requirement documents, project plans, resource identification, funding needs, Gantt charts, and status reporting.
• Make recommendations to leadership on people, process, and technology changes to bring projects back on schedule or within scope.
• Support regional teams to improve execution on ACO or MBO level goals through effective management of reported issues, risks, and follow-ups.
• Share key LOB activities, strategies, projects, and tactics with national PMO team to provide senior executive programmatic reporting.
• Manage work and projects that result in new or enhanced clinical abilities spanning multiple functional areas.

Professional Experience

• Bachelor's degree or 7+ years of commensurate experience required.
• 5+ years of experience in healthcare or health insurance required.
• 4+ years of strong project management or program management experience required, including project scope definition, business requirement gathering, risk identification, project methodology, resource allocation, and facilitation.
• 3+ years of experience gathering and documenting business and operational requirements, determining scope of work in a multi-phase project, and implementing change management required.
• Experience with clinical program development or clinical delivery required.
• Experience in Commercial and Medicaid insurance lines of business preferred.
• Experience in marketing and communications preferred.
• Intermediate proficiency in PowerPoint for creating slides and updating monthly reporting template decks.
• Advanced proficiency in Excel, including summary pivots, charts, trend depiction, and data status reporting.
• Experience with Visio and SharePoint.
• Strong relationship-building skills.
• Ability to influence peers and leadership across multiple business areas.
• Ability to develop executive-ready presentations and materials for internal and external audiences.
• Ability to manage large-scale meetings with external partners and customers.
• Ability to navigate the organization and identify and engage key stakeholders needed to support strategic priorities.
• Experience managing multiple parallel business development efforts.
• Comfortable driving risk mitigation, issue resolution, and reporting status to leadership.

Embedded within a regional managed care structure, the Senior Clinical Program Manager refines care delivery models by co-creating Care Management programs, analyzing value-based care data, and launching clinical initiatives targeting high-risk hospital discharges, palliative care, and disease management. Working closely with the Regional Medical Director and external partners, this role advances the Quadruple Aim by transforming medical groups into high-efficiency, high-quality health organizations.

Ownership Areas

• Assist in the evaluation and identification of opportunities around high-risk clinics and work side by side with external partners in the design and launch of clinical programs focused on high-risk hospital discharges, group visits, pain management, and other initiatives ensuring access to preventative care and decreasing inpatient and emergency department utilization.
• Partner with medical groups to create or redesign care programs focused on ensuring care for the highest-need members.
• Bring care to members who might otherwise be hospitalized or unable to access care.
• Ensure palliative care programs are available where appropriate and when needed.
• Co-create Care Management programs encompassing disease management, complex care management, transitions of care, and multidisciplinary rounding.
• Work with partners to provide guidance and rapid cycle process improvement of programs.
• Conduct day-to-day process analysis and data analysis across all lines of business and innovative value-based care models to support affordability.
• Partner with internal and external teams to transform organizations into high-efficiency, high-quality health organizations.
• Lead with a collaborative approach and an understanding of existing resources and relationships among partner organizations while driving constructive change.
• Participate in the development, design, and launch of innovative care models.
• Prepare reports, graphs, and presentations and illustrate data using spreadsheet, database, and graphic software.
• Provide input into designing strategies for alignment with business unit goals and objectives.

Knowledge Skills & Abilities

• Current, active RN, NP, or PA license required.
• Experience in a clinical healthcare clinic or home care program highly preferred.
• Experience in case utilization, quality improvement, and disease management required.
• In-depth understanding of the managed care delegated model and associated efficiency and quality measures required.
• Health plan experience preferred.
• Proven ability to develop effective action plans and implement to successful conclusion.
• Ability to synthesize and collate information from various sources and create management-level reports and presentations.
• Effectiveness in written and verbal communication style with advanced grammar comprehension.
• Conflict resolution and change management skills with the ability to work with and meet deadlines.
• Ability to multi-task and work closely with all stakeholders involved in the delivery of services.
• Demonstrates tenacity and resourcefulness in seeking creative solutions to challenges.
• Able to anticipate change and respond with a collaborative approach.
• Expert ability to follow up and follow through on all tasks with attention to detail and accuracy.
• Ability to interact with all levels including senior management and influence decision-making.