Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Program Operations & Quality Consultant is responsible for supporting the operational management, regulatory compliance, quality oversight, and performance monitoring of clinical programs. This position combines clinical pharmacy expertise with program coordination, project management, process auditing, and operational excellence activities to ensure programs are clinically sound, compliant, efficient, and aligned with organizational goals.

The role serves as a key liaison between Clinical Program Operations, Development, Regulatory Affairs, Privacy and Business stakeholders. The incumbent will support clinical program standard operating procedures, monitor key performance indicators (KPIs), conduct operational audits, assess program health, and ensure adherence to federal, state, accreditation, and organizational requirements.

Job Responsibilities:

• Support the implementation, maintenance, and optimization of clinical program SOPs, policies and workflow.
• Ensure programs are executed according to established clinical, regulatory, and operational standards.
• Assist in the development and maintenance of workflows, policies, procedures, and operational documentation.

• Provide clinical pharmacy expertise to support program design, implementation, and ongoing operations.

• Support compliance with applicable healthcare regulations and accreditation requirements, including CMS, NCQA, URAC, state Boards of Pharmacy, and other regulatory bodies.

• Support project planning, implementation, and monitoring for clinical and operational initiatives.
• Track project timelines, deliverables, dependencies, and risks.
• Prepare project status reports, presentations, and executive summaries.
• Facilitate stakeholder meetings and ensure accountability for action items.
• Support organizational change management and process improvement efforts.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelor's degree in Project Management

• 3+ years of experience in clinical pharmacy, healthcare operations, managed care, quality, regulatory affairs, or clinical program support

Preferred Experience

• Strong in strategic thinking, problem solving, cross-functional collaboration, time and priority management
• Excellent communication and presentation skills
• Exceptional organizational skills and meticulous attention to detail, with the ability to manage multiple priorities and meet deadlines
• Doctor of Pharmacy (PharmD) degree with active pharmacist license
• Experience with compliance reviews, clinical program management, or quality improvement initiatives
• Knowledge of CMS regulations, NCQA standards, State and federal pharmacy regulations or Healthcare compliance or audit methodologies

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN