Senior Medical Director (AI)

TL;DR

Senior Medical Director (AI): Serving as a clinical ambassador to payer clients, this role involves mapping clinical leadership structures and strengthening advisory relationships to drive the adoption of payment integrity solutions. Focus on providing deep subject matter expertise in health plan payment policies, claims editing methodologies, and translating complex clinical data into actionable business strategies.

Location: Remote (US)

Salary: $216,417–$324,625

Company

An AI-first healthcare technology company dedicated to simplifying the business of care by preventing inaccurate payments and reducing waste in the healthcare ecosystem.

What you will do

• Serve as the primary clinical ambassador to payer clients, engaging with medical directors and CMOs.
• Build and maintain trusted advisory relationships to expand influence within payer organizations.
• Partner with sales and go-to-market teams to support business development and client growth.
• Provide expert guidance on payment policies, claims editing, and their impact on provider networks.
• Represent the company at industry conferences and thought leadership venues.
• Act as a clinical conduit between payer clients and internal product development teams.

Requirements

• M.D. or D.O. degree required.
• 10+ years of experience in payer organizations, provider systems, or healthcare technology.
• 4+ years of experience with primary and secondary code edit frameworks.
• Deep expertise in health plan payment policies, claims operations, and payment integrity.
• Ability to travel up to 40% of the time.
• Must be based in the United States.

Nice to have

• Active or prior state medical license.
• Familiarity with AI methodologies for claims anomaly detection.
• Strong presentation skills for simplifying complex concepts.
• Strategic mindset bridging clinical, operational, and business priorities.

Culture & Benefits

• Inclusive environment focused on collaborative success.
• Opportunity to shape the future of healthcare with AI.
• Recognition as a 2025 Best in KLAS for Pre-Payment Accuracy.
• Commitment to candidate experience and professional growth.