8 Clinical Decisionmaking Jobs

Job Description: As a Consultant Nephrologist at Kailash Hospital & Neuro Institute in Noida, you will play a crucial role in diagnosing and treating medical conditions related to the kidneys. Your responsibilities will include managing patients with acute and chronic kidney diseases, overseeing dialysis treatments, managing hemodialysis units, and consulting on kidney transplant cases. Additionally, you will collaborate closely with medical staff to develop treatment plans, monitor patient progress, and stay updated with the latest advancements in nephrology treatments and techniques. To excel in this role, you must possess a strong background in medicine and nephrology skills, along with experience in dialysis and hemodialysis procedures. Knowledge of transplant processes, exceptional diagnostic and clinical decision-making abilities, as well as excellent communication and interpersonal skills are essential. A degree of M.D. or equivalent in Nephrology, along with relevant certifications and licenses to practice in India, are required qualifications for this position.,

As an Internal Medicine Physician at Gleneagles Hospitals in Chennai, your primary responsibility will be diagnosing and treating a variety of internal medicine conditions. You will conduct patient examinations, interpret diagnostic test results, and collaborate with other specialists to coordinate patient care effectively. Your role will also include maintaining detailed patient records, formulating personalized treatment plans, and offering preventative care advice to patients. To excel in this position, you must possess extensive knowledge of Internal Medicine and demonstrate proficiency in treating a wide range of conditions. Your skills in patient examination, diagnostic test analysis, and clinical decision-making will be crucial for providing high-quality medical care. Effective communication and interpersonal skills are essential for patient interactions and seamless team collaboration within the healthcare setting. Your ability to formulate personalized treatment plans tailored to individual patient needs and provide preventative care guidance will contribute to the overall well-being of your patients. Being detail-oriented with strong record-keeping abilities is vital to ensure accurate documentation and continuity of care. A medical degree and relevant board certification in Internal Medicine are required qualifications for this role. Moreover, any prior experience in using advanced medical technologies and familiarity with international clinical protocols will be considered advantageous in delivering advanced healthcare services. Join our dynamic team at Gleneagles Hospitals and make a positive impact on the healthcare landscape in Chennai.,

As a Consultant Ophthalmologist at Amritsar Eye Clinic, located in Dehradun, Uttarakhand, India, you will play a crucial role in diagnosing and treating various eye conditions, as well as performing surgeries within your specialty. Your responsibilities will include utilizing your strong diagnostic and clinical decision-making abilities to provide high-quality patient care. Excellent patient communication and interpersonal skills are essential for this role, as you will be working closely with a team of dedicated professionals in a team-oriented environment. The ideal candidate for this full-time on-site position will hold an MD / MS in Ophthalmology with a minimum of 2 years of experience post-graduation. Fellowship trained candidates in a sub-specialty will be given preference due to the advanced nature of our services. Your commitment to improving the vision and eye health of our patients, coupled with your attention to detail, will contribute to the exceptional standard of eye care services we provide at Amritsar Eye Clinic.,

As an Ophthalmologist Retina Surgeon, you play a crucial role in providing specialized eye care, particularly in diagnosing and treating disorders of the retina. Your responsibilities include performing surgical procedures on the retina and vitreous, diagnosing and managing retinal conditions such as macular degeneration, diabetic retinopathy, and retinal detachments, utilizing advanced retinal imaging techniques for diagnosis and treatment planning, participating in multidisciplinary team meetings to discuss complex cases, providing pre-operative and post-operative care to patients undergoing retinal surgery, using lasers and other precision instruments for surgical interventions, training and supervising medical staff and residents in retinal surgical techniques, participating in research activities and clinical trials related to retinal diseases, collaborating with other ophthalmologists and healthcare professionals for comprehensive patient care, and communicating treatment plans and prognosis to patients and their families. To qualify for this role, you must hold a medical degree (MBBS/MD) with specialization in Ophthalmology, have completed a fellowship in Vitreo-Retinal Surgery, possess a valid medical license to practice as an Ophthalmologist, be board certified in Ophthalmology with a focus on retinal diseases, have a minimum of 2-5 years of experience in retinal surgical interventions, demonstrate expertise in interpreting retinal imaging and diagnostic tests, exhibit strong surgical skills, particularly in vitrectomy and retinal laser procedures, showcase excellent clinical decision-making abilities for complex retinal cases, be proficient in using ophthalmic diagnostic and surgical equipment, possess exceptional communication and interpersonal skills for patient interactions and team collaboration, and show a commitment to ongoing professional development and staying updated with advancements in retinal care. If you are passionate about surgery, communication, collaboration, team collaboration, medical imaging, clinical decision-making, interventions, treatment planning, patient care, professional development, diagnosis, advanced retinal surgery, interpersonal skills, ophthalmology, clinical trials, and completion, this role may be a great fit for you. For further information, please contact Mr. Manoj Thenua at 63986528-32.,

As a Registered Nurse (RN) with active, unrestricted license in [state], your primary responsibility will be to review and assess clinical information submitted with Prior Authorization (PA) requests to determine medical necessity, appropriateness, and benefit coverage. You will conduct clinical evaluations for outpatient, inpatient, and specialty services, including J-code medications and durable medical equipment (DME) as applicable. It will be essential for you to apply CMS Medicare Advantage guidelines, internal policies, and clinical criteria (such as MCG/InterQual) to make informed decisions. Collaboration will be a key aspect of your role as you work closely with physicians, pharmacists, Utilization Management (UM) staff, and external providers to ensure accurate and timely resolution of cases. In situations involving complex or borderline cases, you will be required to escalate them to Medical Directors for a final determination. Your ability to document decisions, rationale, and communications clearly and accurately in the clinical system of record will be crucial. You will also be expected to provide support for audits, appeals, and compliance-related documentation requests, as well as participate in quality improvement initiatives and workflow optimization. Educating providers and internal teams on medical policy, coverage criteria, and regulatory requirements will be part of your regular responsibilities. To be successful in this role, you should have a minimum of 3 years of clinical experience in Utilization Management, Prior Authorization, Case Review, or related fields, along with at least 2 years of direct experience working with Medicare Advantage plans and understanding CMS requirements. Familiarity with medical management software and PA platforms, such as GuidingCare, TruCare, Epic, or similar, will be advantageous. A working knowledge of MCG/InterQual guidelines and CMS NCD/LCDs is also required. Your excellent clinical decision-making, documentation, and communication skills will be critical in this position. The ability to work independently and efficiently manage high case volumes in a fast-paced environment is essential for success. This is a full-time position with a day shift schedule. The work location is in person, and the job type is Full-time. The required experience includes 2 years of CMS Requirements and 3 years of Clinical experience.,

The doctor will be responsible for providing primary healthcare services to rural communities in the selected Villages of Byadagi Taluk, Haveri district in Karnataka ensuring quality medical care and improved health outcomes. You will conduct OPD consultations and diagnose/treat common illnesses. Additionally, you will provide medical care for children, pregnant & lactating women, and adults. Your role will involve leading and participating in specialist health camps to enhance healthcare access. It will be important for you to identify and refer critical cases (e.g., severe malnutrition, pregnancy complications, critical illnesses) to appropriate healthcare facilities. Collaboration with ASHAs, ANMs, AWWs, and local NGOs/CBOs and key decision-makers will be crucial to ensure effective patient referrals. Conducting nutrition and health education sessions to promote preventive healthcare will also be a part of your responsibilities. Furthermore, maintaining medical records and documenting patient progress for reporting and evaluation will be essential. This role aims to enhance community health access, reduce morbidity, and promote preventive healthcare practices in underserved areas. Key Deliverables: - Conduct regular OPD consultations, diagnose, and treat common illnesses. - Provide comprehensive medical care for children, pregnant & lactating women, and adults. - Lead and participate in specialist health camps to enhance healthcare access. - Identify and refer critical cases to appropriate healthcare facilities. - Collaborate with healthcare personnel and local organizations for effective patient referrals. - Conduct nutrition and health education sessions. - Maintain accurate medical records and document patient progress. - Prepare medicine indents and verify medicine stocks regularly. Qualifications and Experience: - A Registered Medical Practitioner (MBBS/MD/BAMS/BHMS) with Medical Council of India / National Medical Commission / State Medical Council. - Networking with other medical professionals for special health camps. - Relevant experience in Gynecology/Pediatrics/Dermatology/General Medicine/BDS/Orthopedics as needed. Key Competencies: - Medical Expertise & Clinical Decision-Making. - Emergency Care & Referrals. - Community Health & Preventive Care. - Collaboration & Coordination. - Medical Documentation & Inventory Management. You will also be responsible for any other duties as per the timely requirements by the project. Equal Opportunities and Child Safeguarding: Background checks will be conducted to ensure the protection of children from abuse. The post holder is required to follow the BRBs anti-harassment policy to safeguard staff. Save the Children India is dedicated to helping children affected by crises and advocating for their rights. As an organization, we aim for significant breakthroughs in child welfare by 2030. We value our employees and offer a collaborative and inclusive environment where ambition, creativity, and integrity are highly valued. Job Identification: 13497 Job Category: Business Transformation Posting Date: 07/10/2025, 01:18 PM Apply Before: 07/16/2025, 07:48 AM Job Schedule: Part-time Location: SC IND - South - Karnataka,

Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. At Prudential Health India (PHI), we are on a mission to make Indians healthier, while bridging the health protection gap. This is a Zero to One team undertaking a greenfield health insurance deployment in India committed to building journeys that will truly empathize with the customer and offer a differentiated, bespoke experience. To partner us in this mission, we are looking for a talented Manager- Underwriting Management. As a Manager- Underwriting Management, your typical week might include the following: - Define and construct a new age underwriting workflow which is more customer-centric and tech-enabled. - Application of clinical expertise in decision-making. - Evaluation of prevailing underwriting practices & market comparison & analysis of data to help revise UW guidelines. - Alignment with cross-functional key stakeholders. - Owner of process adherence and managing health advisor as well as other partners involved in sourcing. - Mapping & maintaining SLA (Service Level Agreement) & TATs (Turn Around Times). - Define and own underwriting system & rules integrated with sourcing interfaces. - Key opinion holder for cross-functional alignment & projects. - Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data. - Develops/prepares reports and assists in the development of new/revised policies and guidelines based on utilization and clinical trends. - Prepare clinical and medical recommendations based on data summaries, trend analysis, financial analysis, and business analysis. - Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision. - Provides clinical and medical underwriting analysis for pricing and risk assessment selections and eligibility including financial, business, and trend analysis of data critical for decision making in achievement of business objectives. - Manage partner vendors for underwriting process eg., PPMC / MER. - Set up grounds up build for running onboarding and Underwriting management process. - Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate wellness, medical and care management specialty teams to address these identified risks. - Expert in interpretation of ECG / TMT tracings, able to train the teams to opine in a structured format. - Assist and provides clinical and medical analysis on Actuarial research and studies and product development initiatives. - Prepares and may do presentations. Participates in cross-functional teams to develop new/enhanced systems/processes/programs/policies to support business needs. - Performs other duties that may be assigned from time to time. People Management: - Team management; work appraisals and growth of team; develop training, Coaching & Mentoring program; Conflict resolution; Attrition management. You could be the right candidate if you: - Qualification: - Doctor (MBBS preferred /BAMS/BHMS/BDS). - Should be a decisive & creative individual. - Should be able to make quick decisions and have good judgment and analytical skills. - Have excellent verbal and written communication skills and strong negotiation skills. - Always open to embracing change and be able to manage it. - Have 7+ years experience of medical underwriting and at least 6 years of exclusive experience in health insurance underwriting. - Managed team with people from Medical and Non-Medical background. - Manage partners for day to day transactions with focus on the qualitative outcome. This could be the gig for you if you: - Are passionate about consumer behavior and culture; enjoy spending time with customers to understand what they really want. Have an attentive ear listen to new ideas. - Thrive in environments that celebrate co-creation and collaboration. - Have strong clinical knowledge and clinical decision-making skills. - Have built best in class processes from scratch. - Are passionate about leveraging digital tools to transform customer experience. - Like to work in a culture where everyone can see what others are doing. - Take help from others when stuck and encourage others when there are setbacks. - Take full responsibility for your team's contribution output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special: - It's great if you have already read books like Blue Ocean strategy, Measure what matters & Zero to One before you saw them mentioned here. - You have real stories to tell about how your team and you challenged convention and took the path less traveled. - We are keen to listen to your story; doesn't matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. Location: Mumbai Title: Manager- Underwriting Management Reporting to: Senior Manager Underwriting.,

Overview The Intensivist Consultant plays a critical role in providing specialized care to critically ill patients in Bihar. They are responsible for overseeing the management of intensive care patients, making crucial clinical decisions, and collaborating with multidisciplinary teams to optimize patient outcomes. Key Responsibilities Provide expert critical care to patients in the intensive care unit. Assess and manage complex medical cases requiring intensive care. Utilize advanced clinical decision-making skills to develop effective treatment plans. Coordinate with multidisciplinary teams to ensure comprehensive patient care. Perform invasive procedures such as intubation, central line placement, and arterial line placement. Oversee mechanical ventilation and other life support measures. Provide continuous monitoring and adjustment of treatment plans as per patient conditions. Participate in daily rounds and communicate updates to the care team. Act as a patient advocate and ensure their rights and preferences are respected. Contribute to quality improvement initiatives and research in critical care medicine. Participate in teaching and mentoring medical students, residents, and fellows. Remain updated on evidence-based practices and advancements in critical care. Participate in on-call schedules and respond to critical care emergencies. Ensure compliance with relevant regulations and quality standards. Required Qualifications Doctor of Medicine (MD) or equivalent degree in Critical Care Medicine or related field. Board certification in Critical Care Medicine. Proven experience as an Intensivist or in a similar critical care role. Expertise in managing critical care cases, including sepsis, respiratory failure, and hemodynamic instability. Demonstrated proficiency in performing invasive procedures. Strong understanding of advanced life support measures and mechanical ventilation. Excellent clinical judgment and decision-making skills. Ability to collaborate effectively with a diverse healthcare team. Outstanding communication and interpersonal abilities. Commitment to patient advocacy and delivering high-quality care. Capability to work effectively in high-stress and time-sensitive situations. Familiarity with quality improvement processes and research methodologies. Active licensure to practice medicine in Bihar. Willingness to participate in on-call rotations and respond to emergencies. Up-to-date knowledge of critical care guidelines and best practices. Contact Mr Manoj 6398652832,