Join a leading global professional services organization dedicated to building a better working world. We offer extensive training, opportunities, and the creative freedom to shape your career. At EY, we focus on your potential and provide motivating experiences to help you achieve your professional goals. This role is within our National Forensics team, specifically supporting Investigations & Compliance in Gurgaon.

This Senior Consultant role focuses on strengthening trust in healthcare by combating fraud, waste, and abuse (FWA) within government-funded schemes. You will conduct medical audits, identify FWA indicators, refine fraud detection mechanisms, and assess the clinical appropriateness of claims. Responsibilities include providing technical support for claims adjudication, collaborating with stakeholders, delivering training, and preparing comprehensive reports. The position requires contributing to the continuous improvement of fraud prevention and control strategies.

We are seeking candidates with 3 to 6 years of experience. Essential educational qualifications include an MBBS from a recognized Indian university; foreign medical graduates are not considered. A desirable qualification is an MD or other postgraduate medical qualification. Experience in medical audits, claims review, healthcare fraud management, health insurance, or government healthcare schemes is preferred. You should possess a collaborative approach, practical problem-solving skills, and the ability to deliver insightful solutions. Adaptability, creativity, and sustained positive energy are key attributes.