Sr. Medical Director (AI Healthcare)

TL;DR

Sr. Medical Director (AI Healthcare): Serve as clinical ambassador to payer clients, building relationships with medical directors and CMOs to expand influence and support business development with an accent on payment policies, claims editing, and affordability strategies. Focus on communicating editing content, providing policy expertise, and bridging client insights to product development while representing at industry events.

Location: Remote (US)

Salary: $216,417 - $324,625

Company

AI-first healthcare technology platform simplifying care business by preventing inaccurate payments and reducing waste for payers, providers, and patients, with 35 years of pre-pay editing expertise.

What you will do

• Serve as clinical ambassador engaging directly with payer medical directors, operations executives, and CMOs.
• Build trusted relationships to expand influence within payer organizations and identify strategic engagement opportunities.
• Partner with sales and go-to-market teams for new business, renewals, and client growth.
• Provide expertise on payment policies, claims editing, and impacts on providers and costs.
• Communicate policy and editing content to influence adoption and strengthen payment integrity.
• Represent at conferences and forums; conduit client insights to product and content teams.

Requirements

• M.D. or D.O. required
• 10+ years in payer organizations, provider systems, or healthcare tech
• 4+ years with primary and secondary code edit frameworks
• Deep expertise in health plan payment policies and claims editing impacts
• Insight into payment policies and provider network management
• Familiarity with affordability, claims operations, payment integrity, utilization management, or policy development

Nice to have

• Active or prior state medical license
• Outstanding presentation skills to simplify complex concepts
• Familiarity with AI for claims anomaly detection
• Ability to translate policy into actionable strategies
• Strategic mindset bridging clinical, operational, business priorities
• Collaborative success across sales, product, delivery teams
• Willingness to travel up to 40%

Culture & Benefits

• Inclusive environment empowering employees and collaborative success
• HI-TRUST and SOC2 certified
• Total rewards compensation beyond base salary