Doctors Without Borders, an international humanitarian medical association created in 1971, provides medical assistance to populations whose lives are threatened: mainly in cases of armed conflict, but also epidemics, pandemics, natural disasters or exclusion from care.
Reporting to the Director of Operations, the Unit 4 Manager is responsible for their team and the unit’s operations. They manage a portfolio of complex contexts, ensure the strategic and operational coherence of projects, guarantee the quality, relevance, and continuity of interventions, and contribute to defining and implementing MSF OCP’s strategic directions. Working collaboratively with field teams, coordination units, other units, and operational departments, they organize operational decision-making, facilitate deliberation processes, clarify arbitration, formalize key choices, and ensure the coordinated mobilization of expertise necessary for effective portfolio management. This position contributes to the evolution of the unit’s operations by integrating requirements for quality of care, risk management, safeguarding, patient and community participation, and clear responsibilities within the operational chain.
Job Context:
Unit 4 has undergone several portfolio changes in recent years and could retain a flexible role within the Operations Department, for example, to absorb new country openings, support the consolidation of certain missions after their management by the Emergency Unit, or in the event of a unit becoming overloaded.
Its current portfolio covers three very different contexts – Haiti, Afghanistan, and Nigeria. The unit’s non-regional nature necessitates enhanced cross-functional work and continuous coordination with other units regarding expertise, learning, and relevant regional dynamics.
This position aligns with the evolving operational approach at MSF OCP: clarifying roles, strengthening co-construction, subsidiarity, formalizing decisions and arbitration, more coherent mobilization of expertise, and improving the quality of projects serving patients, populations, and teams.
Summary by country
The countries in the cell are heavily impacted by the decline in international aid, leading to increased activity pressure on our projects, requiring reflection on both our intervention and care models and the need to regularly reassess our priorities.
- Haiti: a context marked by instability, fragmented actors, and deteriorating public services; a major challenge in terms of humanitarian access, continuity of care, negotiation of intervention space, and balancing risk levels with maintaining a relevant presence. Two projects are being implemented there, offering a wide range of services from trauma care to general medicine, with a focus on strengthening water and sanitation activities and providing care for victims of sexual violence.
- Afghanistan: a highly constrained political and institutional environment, particularly for women, impacting our colleagues and patients; the need to regularly reassess our position regarding the increasingly severe restrictions imposed on them; while maintaining relevant and appropriate medical services that integrate women’s needs into our approaches, maintaining a nuanced understanding of operational flexibility, and ensuring coherence between medical goals, increased admissions, resources, and contextual constraints. In Afghanistan, we have one of our largest pediatric services in our portfolio, as well as a family health project in rural Bamyan. Our mission in Afghanistan is part of an intersectional model, for which the Clinical Research Coordinator (CR) has a significant responsibility within the inter-desk to implement and collectively champion it with shared responsibility and commitment.
- Nigeria: a multi-crisis urban context where armed conflict, epidemics, and stark inequalities in access coexist; the need to coordinate emergency responses, medium-term perspectives, portfolio coherence, and the capacity to adapt intervention models to evolving contexts. We are currently running three projects simultaneously: our largest project dedicated to addressing malnutrition; our most significant project for managing obstetric emergencies and fistulas, with ever-increasing activity and questions about future directions in a context marked by a limited number of aid actors; and finally, a project providing access to conflict-affected areas in Borno State in partnership with a local association.
- Emergency responses: these 3 countries are experiencing numerous emergencies – natural disasters, peak malnutrition, epidemics and conflicts.
Position and principles of job performance
- The Unit Manager acts at the interface between the organization’s strategic orientations, the realities of the intervention contexts and the actual implementation capacities of the teams.
- He/she leads, with his/her medical-operational partner(s), a central space for integrating medical, operational, ethical and organizational issues in portfolio management.
- He/she structures the exchanges, clarifies responsibilities, organizes collective deliberation, ensures the traceability of decisions and ensures that arbitrations are explained, shared and formalized.
- He/she exercises this responsibility in a logic of subsidiarity: supporting decision-making as close as possible to the field when relevant, while ensuring overall coherence, continuity and respect for the delegation framework.
- He/she ensures the quality of the partnership between the unit, the coordinations, the projects and the departments and helps to protect the teams from the effects of an insufficiently legible organization or fragmented requests.
Main activities
Contribute to the definition of strategy and operational policies
- Participate in defining MSF OCP’s strategy and operational policies and contribute to institutional discussions within its scope.
- To adapt OCP’s strategic orientations to the contexts of the cell and translate them into realistic, prioritized and reasoned operational choices.
- Develop country, regional and/or thematic strategies, by combining context analysis, medical objectives, access issues, risk levels and deployment capacities.
- To establish the merits of projects, propose their objectives and contribute to the decision to open, evolve, close or reorient missions and activities.
- Contribute to the clarity of portfolio priorities and the overall consistency of the unit’s commitments within the framework of the operations department’s arbitrations.
Facilitate, support and guide missions and guarantee the quality of the portfolio
- To be responsible for the relevance, quality, consistency and proper implementation of field projects monitored by the unit.
- To provide strategic and operational support to Heads of Mission and coordination teams, in defining directions, resolving dilemmas, prioritizing actions and managing change.
- Ensure that his team analyzes the contexts of intervention (medical, political, security, logistics, financial, HR, access, taxation, labor law, etc.) and proposes the most suitable operational options.
- Supporting them in politicizing technical issues, negotiating the space for intervention, representing them to key stakeholders, and managing implementation constraints.
- Define and continuously adjust the organization, resources and support methods necessary for the deployment of missions.
- Facilitate portfolio management meetings and ensure the quality of the framework and monitoring materials (country/project sheets, budgets, action plans, reports, risk analyses, capitalizations, etc.).
- Ensure that decisions are informed by contextualized analyses, feedback from the field, the views of the departments involved and, gradually, consideration of patients and populations.
- To ensure the continuous adjustment of operational choices based on changes in context, observed results and discrepancies between initial assumptions and implementation realities.
Organizing the co-construction, arbitration and formalization of decisions
- Structure the spaces for deliberation useful for managing projects and the portfolio, and ensure clarity of roles between recommendation, contribution, decision and arbitration.
- Mobilize business expertise in a coherent manner, at the right time and at the right level, avoiding fragmented or contradictory requests addressed to operational teams.
- To assume the arbitrations falling within one’s level of responsibility and to prepare those to be brought to the Operations Management when the issues exceed the scope of delegation of the cell.
- Formalize and share the key decisions, explaining the reasoning, the assumptions made, the limitations, the compromises and the expected outcomes.
- Contribute to the quality of the operational “decision-making process” by making priorities, room for maneuver and responsibilities at each level more legible.
- Ensure the quality of briefings, debriefings, critical reviews and assessments, and ensure that these spaces allow for the consolidation of analyses, the sharing of learnings and the formalization of decisions.
- Ensure the smooth flow of information between the field, the cell, the Operations Directorate and other departments.
Ensuring risk management, quality of practices and protection of teams
- Constantly weigh actions and risks, propose appropriate measures and ensure that accepted risk levels are discussed and explained.
- To ensure compliance with security procedures, safeguarding, Duty of Care and applicable institutional policies within one’s area of responsibility.
- Contribute to improving the quality of projects by integrating the issues of quality of care, relevance of practices, patient safety and feedback from experience.
- Ensure the inclusion of patient-centered issues, patient and population participation, and the reduction of treatment inequalities in the projects monitored by the unit. Manage the unit’s teams and Mission Leaders hierarchically.
- To recruit, supervise, advise, support, motivate and unite the members of his cell and the Heads of Mission under his hierarchical responsibility.
- To set the direction, define individual and collective objectives, evaluate the work and support the development of employee skills.
- For the business managers in the unit, conduct the assessments with the contribution of the relevant department manager.
- Unless otherwise advised, adapt the composition of the team in the unit according to the needs of the portfolio and the priorities defined.
- To ensure the proper contribution of his unit to cross-functional projects, interdepartmental relations, and the continuity of the operation of the operations department.
- Validate the assignments to the operational coordination positions proposed by the Career Managers, with the support of the HR Manager of the unit.
Manage the budget and resources of the unit
- Develop, manage and monitor the budget for the unit’s and its team’s operations, in line with institutional frameworks and portfolio priorities.
- Contribute to budget arbitration, resource prioritization and adjustment of resources according to evolving needs and contexts.
- To be responsible for achieving the objectives within its scope and for respecting the contracts signed with the lessors when the unit is concerned.
Represent and advocate for the interests of MSF
- Represent MSF within its scope, both internally and externally, and promote the organization’s operational positions in relevant spaces.
- Ensure the smooth flow of information and good coordination with internal and external stakeholders within the scope.
- Where appropriate, propose elements of public communication or advocacy on the subjects relevant to the unit, in coordination with the relevant stakeholders.
Desired profile
Experience
- Significant experience in operational management roles at MSF or in equivalent roles in other organizations: Cell Manager, Deputy Cell Manager, Head of Mission, Medical Coordinator, Director, or other strategic management roles in complex operations.
- Good knowledge of MSF, proven experience in managing complex projects, leading multidisciplinary teams and arbitration in uncertain environments.
SKILLS
- Excellent command of project management and operational portfolio management.
- Ability to conduct complex analyses, structure problems and translate strategic directions into operational decisions.
- Ability to organize collective deliberation, to mobilize relevant expertise and to formalize arbitrations.
- Excellent command of team management, skills development and change management.
- High-level writing, summarizing and presentation skills.
Aptitudes
- Leadership and ability to work under pressure.
- Strong communication skills, excellent listening skills and interpersonal skills.
- Ability to anticipate and prioritize.
- Ability to arbitrate, to take responsibility for decisions and to explain the reasons behind them.
- Ability to work across departments and to get actors with different perspectives to cooperate.
- Rigour, political acumen, discernment and attention to the effects of organizational choices on teams.
LANGUAGES
- Fluent French and English = minimum level B2.
Employment conditions
Status: Permanent full-time contract. Management position, based in Paris with regular travel to MSF field sites.
Compensation and benefits:
- €72,980 gross annual salary over 13 months
- 22 days of RTT (reduced working time) per year
- Working remotely according to MSF’s rules (2 days/week).
- Health insurance covered 100%
- Meal vouchers worth €12 (60% covered by MSF)
- 50% reimbursement of public transport pass (weekly, monthly or annual) OR bicycle mileage allowance (€0.25 per km, limited to €450 per year)
Position available : September 2026
Application deadline: July 24, 2026
How to apply
Thank you for applying directly on the MSF website: Cell 4 Manager (M/F) | Doctors Without Borders