Job Title: Healthcare Consultant

Domain: Global Healthcare -

Experience Required: 3-5

Experience

• 3-5 years of experience in healthcare consulting, business strategy, or healthcare transformation roles.
• Working knowledge and certified on payer and provider applications including EPIC, Cerner, e Clinical Works, FACETS, QNXT, Health Edge, Health Rules and All Scripts.
• Experience in atleast 2 or more areas of HS&W, that includes Health Insurance, Pharma, PBM, Hospital Management, HIS/EMR systems, Care Management, Case Management, Utilization Management, Dental, Vision, Medical, Mental Health, Drug management, drug delivery, sales, Provider management, Network Management, Outreach and Advocacy, Community Programs, prevention and wellness.
• Working experience on Core Insurance solutions for Medicare, Third-Party Claims Administration (TPA), Auto-Adjudication, Claims Adjustment, Explanation of Benefits (EOB), Policy checking, Renewals, Co-pay & Coinsurance, ICD-10, CPT codes, HCPCS codes, HIPAA, Fraud, AML etc
• Consulting engagements included POV’s, Market research, Client Profiling, competitor analysis, SWOT Analysis, GTM strategies, post M&A assessments for existing business across geographies. Built Market understanding Post Obamacare that including Medical Loss Ratio and New Rating Rules, ACOs and HIXs.
• Sound knowledge on HIS modules like Registration, Admission Discharge Transfer, Appointment Scheduling, Financial modules like Account Payables/Receivables, Patients' Accounting & Insurance, EDI , Clinical modules like Care Summary, Clinical documentation, Enterprise Orders and Pharmacy, Electronic Prescribing, Results Reporting and Maternity.
• Have exposure to working on HIPPA, ICD9/ICD10, CPT4, and SNOMED. Sound knowledge of HL7 which is used for interface purposes.
• Project management, Bid management, Daily cadence, brainstorming with the client partners and internal stakeholders to provide qualitative and customized solutions to the prospect.
• Leading healthcare presales and solutions development bids with end-to-end functional ownership for response to RFP/ RFI/proactive pitches and sole discovery opportunities.
• Immense experience in working on large deals, creating transformative solutions, and contributing during all stages of the Sales and Solutions cycle for both Payer and Provider functions.
• Knowledge and experience of working on various financial pricing models to suit to the customers’ requirements.
• Develop proposal storyboards and case studies and conduct proposal quality reviews, client visit management.
• Has managed multiple client implementation simultaneously. Handled teams and multiple other stakeholders
• Has worked on cloud-based solutions with exposures to functional and technical aspects. Ability to do the estimation and total cost of ownership (TCO) of the implementation
• Ability to create future operating model for client
• Has carried out current state and future state analysis and able to do the gap assessment both functional & technical. Provide consultancy to client for the best approach for solution implementation
• Has created work breakdown structure for a product implementation to a client. Has been responsible for product planning and execution throughout the Product Lifecycle, including gathering and prioritizing product and customer requirements, defining the product vision, and working closely with offshore team

Education

• Bachelor’s degree in Business, Healthcare Administration, Public Health, Life Sciences, or a related field.
• Master’s degree strongly preferred (MBA, MHA, MPH, or equivalent).
• Certifications in strategy or healthcare (e.g., Lean Six Sigma, PMP, HFMA) are a plus.

Preferred Background

• Background in top-tier consulting firms, healthcare advisory services, or internal strategy roles within health systems or payers, understanding of healthcare ecosystems across the world universal healthcare, private healthcare and collaborated healthcare operations and regulation.
• Exposure to clinical operations, population health, digital transformation, or payer-provider collaboration, compliances requirements.
• Understanding of emerging technologies (AI, digital front door, remote care, value-based care, etc.) in healthcare delivery.
• Proven ability to work across geographies and diverse regulatory frameworks.

Role Summary

The Healthcare Consultant plays a critical role in shaping and executing high-impact strategies for healthcare organizations across global markets. The role focuses on delivering data-driven insights, strategic planning, market analysis, and transformation roadmaps that align business objectives with healthcare innovation and operational excellence. The consultant works closely with senior leadership to influence strategic direction and decision-making.

Key Responsibilities

• Conduct market and competitive analyses to identify growth opportunities and strategic risks.
• Develop business cases, plans, and investment recommendations for healthcare clients.
• Support organizational transformation efforts including care model redesign, digital health adoption, and operational efficiency.
• Engage with C-level executives, clinical leaders, and technology stakeholders to align strategic goals.
• Publish articles POV’s and thought papers to build client relationships and share current market trends with focus on engaging clients and growth of the account.
• Collaborate with delivery teams and subject matter experts to translate strategy into action.
• Gap analysis and form alliances in the industry; based client needs and strategic requirements.
• Present findings, recommendations, and implementation plans to client leadership and stakeholders.
• Deep knowledge of healthcare policy shifts, emerging trends, and disruptive technologies, awareness and relationships with key industry stakeholders to contribute to the industry trends.

Must-Have Skills

• Strong analytical and problem-solving skills with a strategic mindset.
• Deep knowledge of global healthcare systems, trends and regulations.
• Proven experience in strategic planning, healthcare transformation, or business consulting.
• Excellent communication, facilitation, and executive presentation skills.
• Strong client relationship management and stakeholder engagement capabilities.
• Ability to manage ambiguity and drive clarity in complex environments.

Nice-to-Have Skills

• Experience with digital health, data analytics, or AI strategy.
• Familiarity with public-private healthcare partnerships or health equity initiatives.
• Knowledge of M&A, market entry, or diversification strategies in healthcare.
• Prior experience in value-based care models, population health, or accountable care.
• Exposure to global health challenges.