Clinical Program Operations & Quality Consultant - National Remote
About The Position
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.
Requirements
- Bachelor's degree in Project Management
- 3+ years of experience in clinical pharmacy, healthcare operations, managed care, quality, regulatory affairs, or clinical program support
Nice To Haves
- 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
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.
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
