Using a microscopic theory based on the Maxwell-semiconductor Bloch equations, we investigate the feasibility of an optically pumped electrically driven terahertz (THz) quantum-cascade laser as a pathway to room-temperature THz generation. In optical conversion schemes the power conversion efficiency is limited by the Manley-Rowe relation. We circumvent this constraint by incorporating an electrical bias in a four level intersubband scheme, thereby allowing coherent recovery of the optical pump energy. The observed THz radiation is generated through both stimulated emission and automatically phase-matched quantum coherence contributions--making the proposed approach both a promising source for THz radiation and a model system for quantum coherence effects such as lasing without inversion and electromagnetically induced transparency.