Senior Medical Director

🕒 April 24

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Lyric - Clarity in motion.

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

💳 Fintech

☁️ SaaS

Healthcare Insurance • Fintech • SaaS

Lyric is a leading healthcare technology company focused on payment integrity and accuracy solutions. With over 30 years of experience, Lyric aims to simplify the business of care by leveraging machine learning and predictive analytics to empower health plan payers. The company provides a range of solutions, including Lyric 42 Platform, Pre-Pay Editing, Diagnostics Module, Coordination of Benefits, Concept Libraries, and LyricIQ, which combines AI-powered payment accuracy services. Additionally, Lyric focuses on transparency and responsibility in technology development, ensuring enhanced payment accuracy, administrative efficiencies, and reduced provider abrasion. As a trusted partner in the healthcare industry, Lyric continues to deliver cutting-edge technologies at the crossroads of healthcare and fintech, supporting health plans and providers in the shift to value-based care.

📋 Description

• 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.