Provide timely, high‑quality medical consultations, including interpretation of diagnostic tests, clinical documentation review, and medical risk assessment
Conduct morbidity and mortality reviews to support underwriting and claims‑related decisions
Review and analyze attending physician statements, medical records, lab reports, EKGs, stress tests, and other relevant clinical documentation
Summarize complex medical records and clinical findings to support downstream decision‑making by internal and external medical stakeholders
Review approved claim files to assess the ongoing applicability of medical restrictions or limitations
Medical Research & Analysis
Conduct research on medical conditions and impairments and their relationship to morbidity and mortality
Maintain current knowledge of relevant medical literature, clinical guidelines, and insurance medicine practices
Provide subject matter expertise for large‑scale projects, departmental initiatives, and cross‑functional programs
Training & Staff Development
Develop and deliver medical education and training programs for underwriting, risk management, and claims teams
Coach and support junior or less experienced medical colleagues on case review methodology, clinical reasoning, and documentation standards
Provide ongoing clarification and education through one‑on‑one consultations and group discussions
Operational Responsibilities
Conduct and/or interpret EKG examinations (where applicable based on qualification and scope of practice)
Manage medical referrals based on defined risk thresholds and internal guidelines
Support BAU (Business As Usual) activities, including:
Medical data gathering for tele‑interviews and structured health questionnaires (CMI, SHQs, SHS)
Review of MIB disclosures and sensitive laboratory results
Support for ACLI‑related work and general medical quality assurance activities
Leadership & Collaboration
Act as a Subject Matter Expert (SME) on specialized medical projects and initiatives
Lead complex problem‑solving efforts within the medical team and in collaboration with underwriting, claims, and business partners
Contribute to the development, review, and ongoing maintenance of underwriting medical manuals, policies, and clinical guidelines
Eligibility & Qualifications
MBBS with active license to practice medicine
Active or prior registration/licensure with a relevant professional medical or healthcare authority, where applicable.
Demonstrated ability to analyze, interpret, and apply complex medical and clinical information in a non‑patient‑facing, decision‑support environment
Strong understanding of medical documentation, diagnostic reports, laboratory data, and clinical narratives
Proven capability to assess medical risk, morbidity, and mortality using evidence‑based reasoning and available clinical data
Excellent written and verbal communication skills, with the ability to clearly articulate medical opinions to both clinical and non‑clinical stakeholders
Strong analytical, critical‑thinking, and problem‑solving abilities
Ability to work independently, manage complex casework, and contribute to process improvement initiatives
Demonstrated aptitude for collaboration, mentorship, and knowledge sharing within multidisciplinary teams
Experience in insurance medicine, underwriting support, claims review, population health, utilization management, clinical audit, or healthcare analytics is preferred.
Work Location & Schedule
This role is based out of the Hyderabad office and follows a hybrid working model.
Work schedules and shift timings will be aligned with the reporting Medical Director and Mass Mutual US stakeholders, based on business requirements.
