Saransh Inc · 3 months ago
Domain Consultant
Santa Clarita, CA
Full-time
Onsite
Senior Level
7+ years expSaransh Inc is seeking an experienced Domain Consultant with expertise in the Pre-Authorization space within Life Sciences and Healthcare. The role involves acting as a subject matter expert, supporting clients in transforming pre-auth processes, and advising on compliance with regulations while collaborating with various teams to drive strategic engagements.
EmploymentInformation TechnologyStaffing Agency
Responsibilities
Act as a subject matter expert (SME) in pre-authorization workflows, covering medical necessity, clinical documentation, prior authorization rules, and payer–provider interactions
Support clients in transforming pre-auth processes to improve speed, compliance, and patient experience
Analyze existing business processes, identify gaps, and design target operating models for pre-auth
Partner with technology teams to shape digital and GenAI solutions (e.g., automated prior authorization, real-time benefit checks, interoperability with EMR/EHR)
Advise on compliance with CMS, FDA, and global regulations around pre-authorization, patient safety, and access
Collaborate with product managers, architects, and delivery teams to ensure business requirements are translated into solution designs
Conduct workshops with client stakeholders to gather business requirements, define KPIs, and build consensus
Contribute to thought leadership (white papers, PoVs, webinars) on pre-auth trends and innovation in life sciences
Qualification
Required
7–12 years of domain experience in Life Sciences, Healthcare, or Payer/Provider organizations, with at least 3–5 years focused on pre-authorization or utilization management
Strong knowledge of prior authorization workflows (medical and pharmacy benefits)
Strong knowledge of interoperability standards (HL7 FHIR, X12, NCPDP)
Strong knowledge of clinical guidelines and evidence-based medical policy
Strong knowledge of patient access and affordability challenges
Exposure to payer and provider systems (EHR, claim processing, benefit management)
Experience in consulting or business analysis roles, preferably with global clients
Proven ability to liaise between business and technology teams
Excellent communication, presentation, and stakeholder management skills
Preferred
Experience with CMS interoperability mandates (e.g., CMS-0057-F, PA APIs)
Knowledge of life sciences value chain (pharma/biotech market access, hub services, patient support programs)
Familiarity with AI/ML and automation use cases in pre-auth and utilization management
Prior experience in a consulting firm or digital transformation environment
Bachelor's or Master's degree in Life Sciences, Healthcare Management, Pharmacy, or related field; MBA preferred
Company
Saransh Inc
We provide recruitment, consulting and IT services for our clients, which focus on maximizing their revenue generation, enhancing business productivity and improving cost management.
51-200 employees
H1B Sponsorship
Saransh Inc has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (35)
2024 (51)
2023 (45)
2022 (30)
2021 (22)
2020 (39)
Funding
Current Stage
Growth StageLeadership Team
Sridhar Chimaladinne
FOUNDER & CEO
Company data provided by crunchbase