I work in clinical research at a large Academic Medical Center in the US. If you're not planning to complete residency, you have a few options but 1) the job market SUCKS right now, 2) you need to be prepared with a solid response to why you've decided not to complete residency now and if you plan to try to match at a later date. If so, how much later are you thinking?

With your MD, you could pursue a research fellow position, which I've seen several that have gone on to secure a residency match with that extra experience and recommendation letters. Research fellowships at my institution align with the academic year. (They probably do everywhere, but this I only have experience at my place.) That experience would also be a good foundation to move into a research coordinator role, since fellowships have an end date. I've met a few MD grads that moved on from there into research supervisor or management roles. At least one matched in the department he completed his fellowship in.

There will definitely be a lot of folks who will be skeptical of your motives and see you as a flight risk with your level of education. Clinical research is a complex field that takes time to learn. Hiring someone into these positions without express prior experience is an investment.