Sr. Medical Director

Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI.

The Senior Medical Director is a senior clinical leader who will represent Lyric in strategic engagements with payer clients. This individual will proactively map, establish, and strengthen relationships across payer clinical organizations — from operational leaders through to Chief Medical Officers (CMOs).

ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES

• 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. [Excellent relationship-building skills are essential.]

• 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.

REQUIRED QUALIFICATIONS

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.

PREFERRED QUALIFICATIONS

• 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.

***The US base salary range for this full-time position is:

$216,417.00 - $324,625.00

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***

Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.