Senior Clinical Practice Performance Consultant

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 and 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 initiativesLeads complex clinical analyses and cross-functional workstreams without relying on direct supervisory authorityInfluences enterprise and program decisions through evidence, clinical judgment, structured analysis, and stakeholder engagementProvides recommendations and escalates material risks while partnering with the accountable functions responsible for final legal, compliance, credentialing, medical, policy, and operational determinationsMay mentor peers, guide project teams, facilitate governance activities, and provide functional leadership for assigned initiativesYou'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:  Clinical Strategy and PerformanceProvide senior-level clinical consultation for OSHS programs, enterprise initiatives, new service lines, and strategic growth opportunitiesEvaluate clinical models for safety, quality, regulatory alignment, contractual compliance, operational feasibility, scalability, and workforce readinessDevelop 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 guidanceTranslate complex clinical and regulatory requirements into practical standards for program leadership, operations, and frontline implementationIdentify enterprise-level clinical gaps, inconsistencies, and opportunities for standardization across programsApply High Reliability Organization principles to clinical decision-making, risk identification, and continuous improvementClinical Business Development and SolutioningServe as the clinical SME for RFIs, RFPs, contract modifications, capture activities, solutioning sessions, and new-business developmentInterpret solicitation and contract requirements to define clinical services, care modalities, workflows, staffing models, professional qualifications, supervision structures, and quality requirementsConduct clinical gap and capability analyses comparing customer requirements with organizational resources, policies, infrastructure, technology, and workforce capacityDevelop or review clinical narratives, staffing assumptions, qualification matrices, scope-of-service descriptions, transition plans, readiness requirements, and implementation strategiesContribute to Quality Control Plans, Quality Management Plans, clinical metrics, audit methodologies, corrective-action pathways, and performance-monitoring structuresIdentify clinical assumptions, dependencies, risks, cost drivers, and implementation requirements during proposal development and post-award transitionScope of Practice, Licensure, Delegation, and SupervisionResearch 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 modelsDevelop 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 rolesEvaluate permitted functions, prohibited functions, supervision requirements, delegation rules, documentation expectations, competency requirements, and jurisdiction-specific limitationsAssess proposed staffing and workforce models against practice acts, board rules, federal authorities, contract requirements, credentialing standards, and internal policiesAdvise on compact participation, federal exceptions, telehealth licensure, OCONUS considerations, and program-specific authorizationDevelop, evaluate, and maintain governance frameworks for collaborative-practice, supervisory, delegation, and clinical-oversight relationships involving physicians, advanced practice clinicians, nurses, and other regulated professionalsAssess state-specific agreement, filing, notification, alternate-covering practitioner, physician-availability, quality-review, and documentation requirements and support implementation with accountable enterprise partnersDesign 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 pathwaysIdentify and escalate unresolved scope, licensure, credentialing, supervision, or delegation risks to the appropriate accountable functionClinical Policy and Document GovernanceLead 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 toolsEnsure clinical documents reflect evidence-based practice, professional standards, applicable requirements, accreditation expectations, contract obligations, and operational workflowsCoordinate interdisciplinary review with clinical SMEs, Operations, Legal, Compliance, Quality, Credentialing, Medical Directors, Enablement, and affected stakeholdersSupport document intake, assignment, version control, approval, publication, change control, archival, and periodic reviewMaintain traceability between source requirements, clinical decisions, approved standards, training, workflows, and audit toolsIdentify conflicting, duplicative, outdated, or unsupported clinical documents and recommend consolidation or remediationRegulatory, Accreditation, and Evidence SurveillanceMonitor and analyze changes in federal and state healthcare requirements, professional-practice standards, public-health guidance, and accreditation expectations that may affect OSHS operationsConduct targeted regulatory and clinical research using authoritative primary sourcesDevelop impact assessments that distinguish explicit requirements, interpretation, operational implications, risks, and recommended actionsEvaluate changes affecting licensure, telehealth, occupational health, medication administration, laboratory services, infection prevention, medical equipment, clinical documentation, delegation, supervision, and workforce qualificationsTranslate requirements into recommended changes to policy, training, workflow, quality controls, and operational processesMaintain documented evidence, source citations, effective dates, jurisdictional limitations, and unresolved questionsMonitor pending legislation, proposed regulations, board actions, compact developments, and emerging professional standards; assess anticipated impact and recommend proactive policy, staffing, contracting, training, or implementation changesClinical Risk, Quality, and Patient SafetyIdentify clinical, regulatory, operational, workforce, and patient-safety risks associated with current and proposed servicesConduct or support risk assessments, gap analyses, root cause analyses, incident reviews, failure-mode evaluations, and corrective-action planningEvaluate the clinical implications of audit findings, documentation trends, complaints, adverse events, near misses, performance metrics, and operational variationRecommend risk controls, escalation pathways, monitoring methods, competency requirements, and corrective or preventive actionsSupport development of audit criteria, surveillance tools, readiness assessments, clinical dashboards, and quality indicatorsEnsure identified risks are clearly documented, assigned to an accountable owner, escalated appropriately, and monitored to resolutionClinical Workforce and Care-Delivery Model DesignDesign or evaluate workforce models for fixed-site, mobile, virtual, embedded, event-based, surge, occupational-health, and home-based servicesDefine appropriate clinical roles, qualifications, staffing ratios, supervision structures, escalation coverage, competency requirements, and operational boundariesAssess the suitability of licensed and unlicensed personnel for proposed clinical functionsEvaluate workforce models for patient safety, legal scope, operational feasibility, workforce availability, cost implications, and scalabilitySupport development of job descriptions, role profiles, competency frameworks, interview criteria, resume-review standards, and onboarding requirementsAdvise on innovative staffing approaches while ensuring alignment with scope, licensure, policy, and contract requirementsEvaluate 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 careDifferentiate clinical requirements according to program purpose and legal structure, including treatment, occupational health, medical surveillance, disability evaluation, readiness assessment, triage, advisory, and administrative examination modelsEvaluate 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 functionsTraining, Onboarding, and Competency OversightDefine clinical learning requirements for new programs, clinical roles, policies, workflows, and regulatory changesClinically review onboarding, sustainment, remediation, and annual competency content developed by Enablement or other training ownersEnsure 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 expectationsEvaluate training effectiveness and recommend updates based on audit findings, operational feedback, incidents, regulatory changes, and performance trends.Occupational and Environmental Health ConsultationProvide clinical consultation for occupational health, medical surveillance, workforce health, infection prevention, exposure response, vaccination, fitness-for-duty, and employee-safety programsEvaluate workplace clinical protocols, employee-health workflows, medical-screening requirements, exposure risks, and field-safety considerationsEstablish 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 requirementsAssess clinical and workforce risks associated with mobile, home-based, remote, and field operations, including home-entry protocols, lone-worker safety, environmental hazards, emergency communication, transportation and vehicle liability, equipment and supply security, infection control, accompaniment criteria, and field-readiness requirements.Collaborate with Environmental and Occupational Health, Operations, Legal, Compliance, and program leadership on risk mitigation and implementationTechnology and Clinical Workflow ConsultationDefine clinical, documentation, safety, privacy, quality, and workflow requirements for electronic health records, clinical platforms, digital tools, telehealth solutions, and emerging technologiesTranslate clinical operations into functional business and system requirementsLead or support development of clinical and information-governance requirements for electronic health records and related platforms, including longitudinal record management, active and inactive diagnoses, problem-list reconciliation, continuity of care, role-based access, patient versus employer visibility, occupational-health record separation, PHI controls, audit trails, clinical decision support, and contract-specific reporting.Participate in system selection, requirements development, workflow mapping, user-acceptance planning, implementation, and optimizationEvaluate whether proposed technology supports safe care, regulatory compliance, contractual reporting, clinical governance, and auditability  You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 nursing, healthcare, public health or healthcare administrationActive, unrestricted Registered Nurse license, MSN, BSN, RN, NP  8+ years of progressive clinical, healthcare operations, quality, regulatory, program-development, or consulting experienceSignificant experience interpreting and applying federal and state healthcare requirements, professional-practice standards, clinical policy, or accreditation requirements.Experience developing, reviewing, or implementing clinical policies, SOPs, workflows, standards, or quality-management documentsExperience evaluating clinical scope of practice, licensure, delegation, supervision, credentialing, or professional qualificationsExperience leading complex, cross-functional clinical initiatives in a matrixed organizationDemonstrated ability to synthesize complex clinical, regulatory, contractual, and operational information into practical recommendationsDemonstrated experience communicating with senior leaders, clinical SMEs, operational teams, and nonclinical stakeholdersAdvanced proficiency with Microsoft Word, Excel, PowerPoint, Teams, and SharePointAbility to manage multiple high-priority assignments with competing deadlines and incomplete or evolving informationUnited States citizenship is required for this positionAbility to obtain and maintain a suitability or determination of eligibility for a Confidential/Secret or Top Secret security clearance25 % travelPreferred Qualifications:Master of Science in Nursing, healthcare administration, public health, business administration, or a related advanced degreeExecutive MBA or other advanced business, strategy, or healthcare leadership education10+ years of progressive clinical and healthcare leadership experienceExperience in federal healthcare, government contracting, military health, Veterans' health, public health, occupational health, or distributed national care delivery.Experience with RFI/RFP responses, capture activities, proposal development, clinical solutioning, Quality Control Plans, or post-award transitionExperience with clinical governance, Joint Commission accreditation, High Reliability Organization implementation, quality improvement, or patient-safety systems.Experience designing innovative workforce and supervision models across multiple jurisdictionsExperience developing multi-state regulatory matrices, collaborative or supervisory agreement frameworks, telehealth and telepresenter models, or enterprise clinical governance tools.Experience with telehealth, mobile clinical services, occupational-health programs, medical-disability examinations, readiness programs, or episodic-care models.Experience evaluating electronic health records, clinical technology, documentation systems, or digital clinical workflowsProject-management, process-improvement, quality, compliance, legal-nurse-consulting, or healthcare-executive credentialsExperience mentoring clinical professionals or onboarding senior clinical consultants*All employees working remotely 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 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.  UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.