Senior Clinical Practice Performance Consultant

UnitedHealth Group; La Crosse (WI); Remote; USD 120,000 - 180,000; Full time

Job summary

Logistics Health Incorporated (LHI), part of the Optum family, is seeking a Senior Clinical Practice Performance Consultant to provide enterprise-level clinical consultation across OSHS programs, policy, and governance. You will translate federal and state requirements into practical standards for leadership and operations while supporting risk, quality, and improvement initiatives.

The role emphasizes cross-functional collaboration with Legal, Compliance, Medical Directors, Enablement, and

Qualifications

• Senior clinical SME delivering enterprise-level consultation across programs and strategic initiatives.
• Translate federal and state requirements into practical standards for leadership, operations, and governance.
• Develop and maintain enterprise clinical governance architecture, policies, and regulatory crosswalks.
• Support clinical risk, quality, and patient-safety initiatives across OSHS programs.

Responsibilities

• Provide senior-level clinical consultation for OSHS programs, enterprise initiatives, and strategic growth opportunities.
• Evaluate clinical models for safety, quality, regulatory alignment, contractual compliance, operational feasibility, scalability, and workforce readiness.
• Develop enterprise clinical governance architecture, including governance charters and compliance frameworks.
• Translate complex clinical and regulatory requirements into practical standards for program leadership, operations, and frontline implementation.
• Identify enterprise-level clinical gaps and opportunities for standardization across programs.

Skills

Clinical strategy

Regulatory compliance

Quality assurance

Cross-functional collaboration

Job description

Explore opportunities with Logistics Health Incorporated (LHI), part of the Optum family of business. We're dedicated to simplifying the logistics of complex workforce health programs with cost-effective solutions and a seamless distribution process. With offices in La Crosse, Wis., a satellite office in Chicago and remote employees throughout the country, we have a variety of rewarding career opportunities for you. Elevate your career as you help us create a healthier tomorrow for everyone and discover the meaning behind Caring. Connecting. Growing together.

The Senior Clinical Practice Performance Consultant is a senior clinical subject matter expert within Optum Serve Health Services' Clinical Quality & Patient Safety function. The position provides enterprise-level consultation across clinical strategy, quality, regulatory alignment, policy and document governance, clinical business development, workforce and care-delivery model design, operational readiness, technology enablement, and continuous improvement. The consultant translates federal and state requirements, contract obligations, accreditation standards, evidence-based practices, and clinical operations into practical, scalable, and audit-ready solutions. The role develops and maintains multi-state clinical regulatory infrastructure; evaluates telehealth, telepresenter, mobile, home-based, occupational-health, readiness, and evaluative examination models; and supports collaborative-practice and supervisory governance for regulated clinical professionals. The role partners across Business Development, Capture and Proposal teams, Care Delivery, Program Operations, Quality, Compliance, Legal, Credentialing, Medical Directors, Clinical Enablement, Product, Technology, Privacy, Finance, Human Capital, Environmental and Occupational Health, and other enterprise functions. The Senior Clinical Practice Performance Consultant supports established programs and new initiatives by defining clinical service models, evaluating scope of practice and licensure requirements, developing and maintaining clinical policies, internal standards, identifying clinical and operational risk, supporting quality and surveillance activities, reviewing training and competency requirements, and advising on implementation and performance improvement.

Role Scope and Level of Influence:

• Serves as a senior enterprise individual contributor and clinical advisor across multiple programs, functions, and strategic initiatives
• Leads complex clinical analyses and cross-functional workstreams without relying on direct supervisory authority
• Influences enterprise and program decisions through evidence, clinical judgment, structured analysis, and stakeholder engagement
• Provides recommendations and escalates material risks while partnering with the accountable functions responsible for final legal, compliance, credentialing, medical, policy, and operational determinations
• May mentor peers, guide project teams, facilitate governance activities, and provide functional leadership for assigned initiatives

You’llenjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Clinical Strategy and Performance
  • Provide senior-level clinical consultation for OSHS programs, enterprise initiatives, new service lines, and strategic growth opportunities
  • Evaluate clinical models for safety, quality, regulatory alignment, contractual compliance, operational feasibility, scalability, and workforce readiness
  • Develop and maintain enterprise clinical governance architecture, including governance charters, internal clinical standards, regulatory crosswalks, gap-assessment frameworks, evidence and artifact requirements, decision pathways, accountability structures, and implementation guidance
  • Translate complex clinical and regulatory requirements into practical standards for program leadership, operations, and frontline implementation
  • Identify enterprise-level clinical gaps, inconsistencies, and opportunities for standardization across programs
  • Apply High Reliability Organization principles to clinical decision-making, risk identification, and continuous improvement
• Clinical Business Development and Solutioning
  • Serve as the clinical SME for RFIs, RFPs, contract modifications, capture activities, solutioning sessions, and new-business development
  • Interpret solicitation and contract requirements to define clinical services, care modalities, workflows, staffing models, professional qualifications, supervision structures, and quality requirements
  • Conduct clinical gap and capability analyses comparing customer requirements with organizational resources, policies, infrastructure, technology, and workforce capacity
  • Develop or review clinical narratives, staffing assumptions, qualification matrices, scope-of-service descriptions, transition plans, readiness requirements, and implementation strategies
  • Contribute to Quality Control Plans, Quality Management Plans, clinical metrics, audit methodologies, corrective-action pathways, and performance-monitoring structures
  • Identify clinical assumptions, dependencies, risks, cost drivers, and implementation requirements during proposal development and post-award transition
• Scope of Practice, Licensure, Delegation, and Supervision
  • Research and assess federal and state requirements affecting licensed professionals, unlicensed assistive personnel, telehealth practice, mobile care, occupational health, home-based services, and other care-delivery models
  • Develop and maintain scope-of-practice standards and reference tools for physicians, advanced practice clinicians, nurses, medical assistants, emergency medical personnel, technicians, and other clinical or ancillary roles
  • Evaluate permitted functions, prohibited functions, supervision requirements, delegation rules, documentation expectations, competency requirements, and jurisdiction-specific limitations
  • Assess proposed staffing and workforce models against practice acts, board rules, federal authorities, contract requirements, credentialing standards, and internal policies
  • Advise on compact participation, federal exceptions, telehealth licensure, OCONUS considerations, and program-specific authorization
  • Develop, evaluate, and maintain governance frameworks for collaborative-practice, supervisory, delegation, and clinical-oversight relationships involving physicians, advanced practice clinicians, nurses, and other regulated professionals
  • Assess state-specific agreement, filing, notification, alternate-covering practitioner, physician-availability, quality-review, and documentation requirements and support implementation with accountable enterprise partners
  • Design and maintain enterprise regulatory matrices, quick-reference guides, decision tools, and state-specific implementation resources with defined source standards, review cadence, change tracking, and validation pathways
  • Identify and elevate unresolved scope, licensure, credentialing, supervision, or delegation risks to the appropriate accountable function
• Clinical Policy and Document Governance
  • Lead or support the research, drafting, review, revision, standardization, and maintenance of clinical policies, procedures, standards, SOPs, work instructions, protocols, job descriptions, clinical forms, and implementation tools
  • Ensure clinical documents reflect evidence-based practice, professional standards, applicable requirements, accreditation expectations, contract obligations, and operational workflows
  • Coordinate interdisciplinary review with clinical SMEs, Operations, Legal, Compliance, Quality, Credentialing, Medical Directors, Enablement, and affected stakeholders
• Regulatory, Accreditation, and Evidence Surveillance
  • Monitor and analyze changes in federal and state healthcare requirements, professional-practice standards, public-health guidance, and accreditation expectations that may affect OSHS operations
  • Conduct targeted regulatory and clinical research using authoritative primary sources
  • Develop impact assessments that distinguish explicit requirements, interpretation, operational implications, risks, and recommended actions
  • Evaluate changes affecting licensure, telehealth, occupational health, medication administration, laboratory services, infection prevention, medical equipment, clinical documentation, delegation, supervision, and workforce qualifications
  • Translate requirements into recommended changes to policy, training, workflow, quality controls, and operational processes
  • Maintain documented evidence, source citations, effective dates, jurisdictional limitations, and unresolved questions
  • Monitor pending legislation, proposed regulations, board actions, compact developments, and emerging professional standards; assess anticipated impact and recommend proactive policy, staffing, contracting, training, or implementation changes
• Clinical Risk, Quality, and Patient Safety
  • Identify clinical, regulatory, operational, workforce, and patient-safety risks associated with current and proposed services
  • Conduct or support risk assessments, gap analyses, root cause analyses, incident reviews, failure-mode evaluations, and corrective-action planning
  • Evaluate the clinical implications of audit findings, documentation trends, complaints, adverse events, near misses, performance metrics, and operational variation
  • Recommend risk controls, escalation pathways, monitoring methods, competency requirements, and corrective or preventive actions
  • Support development of audit criteria, surveillance tools, readiness assessments, clinical dashboards, and quality indicators
  • Ensure identified risks are clearly documented, assigned to an accountable owner, escalated appropriately, and monitored to resolution
• Clinical Workforce and Care-Delivery Model Design
  • Design or evaluate workforce models for fixed-site, mobile, virtual, embedded, event-based, surge, occupational-health, and home-based services
  • Define appropriate clinical roles, qualifications, staffing ratios, supervision structures, escalation coverage, competency requirements, and operational boundaries
  • Assess the suitability of licensed and unlicensed personnel for proposed clinical functions
  • Evaluate workforce models for patient safety, legal scope, operational feasibility, workforce availability, cost implications, and scalability
  • Support development of job descriptions, role profiles, competency frameworks, interview criteria, resume-review standards, and onboarding requirements
  • Advise on innovative staffing approaches while ensuring alignment with scope, licensure, policy, and contract requirements
  • Evaluate telehealth, telepresenter, remote-supervision, and hybrid service models, including clinical appropriateness, physical-examination limitations, personnel qualifications, documentation standards, technology dependencies, escalation pathways, and requirements for in-person care
  • Differentiate clinical requirements according to program purpose and legal structure, including treatment, occupational health, medical surveillance, disability evaluation, readiness assessments, triage, advisory, and administrative examination models
  • Evaluate task-level authority and competency requirements for ancillary procedures and diagnostic services, including phlebotomy, electrocardiography, spirometry and pulmonary function testing, ankle-brachial index testing, medication-related activities, specimen handling, and telepresenter-assisted examination functions
• Training, Onboarding, and Competency Oversight
  • Define clinical learning requirements for new programs, clinical roles, policies, workflows, and regulatory changes
  • Clinically review onboarding, sustainment, remediation, and annual competency content developed by Enablement or other training owners
  • Ensure training aligns with approved policy, scope of practice, licensure, delegation, supervision, contractual obligations, and operational expectations.
  • Develop or contribute specialized clinical subject-matter content when required.
  • Establish clinical competency criteria, validation methods, assessor qualifications, reassessment requirements, and documentation expectations
  • Evaluate training effectiveness and recommend updates based on audit findings, operational feedback, incidents, regulatory changes, and performance trends.
• Occupational and Environmental Health Consultation
  • Provide clinical consultation for occupational health, medical surveillance, workforce health, infection prevention, exposure response, vaccination, fitness-for-duty, and employee-safety programs
  • Evaluate workplace clinical protocols, employee-health workflows, medical-screening requirements, exposure risks, and field-safety considerations
  • Establish or evaluate clinical standards and operational controls for medications, vaccines, laboratory and point-of-care testing, medical equipment, supplies, specimen handling, infection prevention, temperature control, emergency response resources, and regulated medical waste, including personnel authorization, competency, maintenance, quality control, documentation, and escalation requirements
  • Assess clinical and workforce risks associated with mobile, home-based, remote, and field operations, including home-enter Protocols, lone-worker safety, environmental