BC-Sector-Health Care-Clinical Consultant-Clinical Domain Specialist-Senior
EY · Bengaluru
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Job Description: Clinical Consultant / Clinical Domain Specialist
Role Overview
We are seeking a Clinical Consultant / Clinical Domain Specialist with a deep understanding of provider and payer workflows and strong expertise in clinical documentation and end-to-end healthcare operations. The ideal candidate will bring hands-on experience across clinical workflows, documentation improvement, and regulatory alignment, supporting healthcare consulting engagements with both strategic insight and execution capability.
Key Responsibilities
- Map end-to-end clinical workflows across inpatient, outpatient, and ambulatory care settings.
- Support Clinical Documentation Improvement (CDI) initiatives to improve accuracy, completeness, and compliance.
- Understand and apply medical necessity, charge capture, and reimbursement requirements within workflows.
- Identify workflow inefficiencies, documentation gaps, and operational improvement opportunities.
- Collaborate closely with clinicians, operations, revenue cycle, and IT teams.
- Support alignment between provider clinical documentation and payer requirements.
- Contribute to process redesign, policy updates, and consulting deliverables.
- Prepare documentation including workflow maps, requirement artifacts, and recommendations.
Required Skills & Qualifications
- 4–8 years of experience in clinical, healthcare operations, or healthcare consulting roles.
- Strong understanding of provider and payer clinical workflows and operations.
- Hands-on experience with Clinical Documentation Improvement (CDI).
- Knowledge of medical necessity, charge capture, reimbursement, and audit readiness.
- Strong familiarity with EMR/EHR systems such as Epic or Cerner.
- Experience working with cross-functional clinical, operational, and technology teams.
- Excellent communication, analytical, and stakeholder management skills.
Preferred Qualifications
- Experience working with US healthcare providers, payers, or integrated delivery networks.
- Exposure to utilization management, care coordination, or revenue cycle processes.
- Knowledge of healthcare regulations including HIPAA, CMS guidelines, and quality programs.
- Prior healthcare consulting or client-facing experience.
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