Clinical Consultant

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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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