Sr. Medical Director

TBC Corporation

21h

About The Position

Lyric is an AI-first, platform-based healthcare technology company focused on simplifying the business of care by preventing inaccurate payments and reducing waste in the healthcare ecosystem. The company aims to enable 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, recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity, HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. The Senior Medical Director is a senior clinical leader responsible for representing Lyric in strategic engagements with payer clients, proactively mapping, establishing, and strengthening relationships across payer clinical organizations, from operational leaders to Chief Medical Officers (CMOs).

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.

Nice To Haves

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.

Responsibilities

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.