Senior Medical Director

Role Overview

• Serve as Lyric’s clinical ambassador to payer clients, engaging directly with medical directors, clinical operations executives, and CMOs.
• Build trusted advisory relationships that expand Lyric’s influence within payer organizations.
• Map client clinical leadership structures and proactively identify opportunities for strategic engagement.
• Partner with go-to-market and sales teams to support new business development, renewal discussions, and client growth initiatives.
• Provide expertise on health plan payment policies, claims editing methodologies, and their downstream impact on provider networks and cost-of-care strategies.
• Communicate Lyric’s payment policy and editing content in ways that inform, advise, and influence adoption, ensuring clients strengthen their payment integrity programs while advancing Lyric’s market impact and value capture.
• Offer deep subject matter expertise in payer affordability, medical and reimbursement policy, and primary and secondary code edits.
• Represent Lyric at industry conferences, client forums, and thought leadership venues as a credible clinical and policy voice.
• Act as a conduit of clinical and policy information from payer clients to Lyric’s content, product, and solution development teams.
• Support development of go-to-market strategies, sales collateral, and solution positioning with a strong clinical and policy perspective.

Requirements

• M.D or D.O. required
• 10+ years of experience in payer organizations, provider systems, or healthcare technology companies.
• 4+ years experience with primary and secondary code edit frameworks.
• Deep expertise in health plan payment policies and claims editing, with a strong understanding of their impact on provider networks and payer-provider relationships.
• Insight into industry-standard payment policies and provider network management approaches in order to better consult with and inform Lyric’s clients.
• Familiarity with affordability, claims operations, payment integrity, utilization management, medical policy and/or benefit policy development.
• Active or prior state medical license (if retired from practice).
• Outstanding presentation skills with the ability to simplify complex concepts for diverse audiences.
• Familiarity with AI methodologies for claims anomaly detection and their applications in payment integrity programs.
• Proven ability to translate complex clinical and payment policy content into actionable strategies for adoption.
• Strategic mindset with ability to bridge clinical, operational, and business priorities.
• Collaborative approach, with success working across sales, product, and client delivery teams.
• Willingness and ability to travel up to 40% of the time.