This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Sr. Medical Director in United States.
This senior clinical leadership role sits at the intersection of healthcare, policy, and technology, supporting strategic payer relationships and advancing payment integrity initiatives at scale. The position serves as a key clinical ambassador, engaging directly with medical directors, clinical executives, and Chief Medical Officers across payer organizations. It combines deep subject matter expertise in health plan payment policy, claims editing, and affordability strategies with a strong external-facing advisory function. The role plays a critical part in shaping how clinical and payment policies are understood, adopted, and operationalized within complex healthcare ecosystems. It also contributes directly to product, content, and go-to-market strategy by translating clinical insights into actionable business impact. This is a highly visible position for a physician leader who thrives in strategic engagement, thought leadership, and cross-functional collaboration.
Accountabilities:- Serve as the primary clinical representative in strategic engagements with payer organizations, including medical directors, clinical operations leaders, and Chief Medical Officers.
- Build and maintain trusted advisory relationships across payer clinical leadership structures to expand influence and partnership depth.
- Map client organizational and clinical decision-making structures to identify strategic engagement opportunities.
- Partner with sales and go-to-market teams to support new business development, renewals, and client expansion initiatives.
- Provide expert guidance on health plan payment policies, claims editing frameworks, and their impact on cost-of-care and provider networks.
- Translate complex clinical and payment policy concepts into clear, actionable insights that support client adoption and program effectiveness.
- Represent the organization at industry events, conferences, and client forums as a clinical and policy thought leader.
- Act as a bridge between payer clients and internal product, content, and solution teams to inform development and innovation.
- Contribute to go-to-market strategy, positioning, and sales enablement materials from a clinical and policy perspective.
- Support advancement of payment integrity strategies through clinical expertise and market insight.
Requirements:
- Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) required.
- 10+ years of experience in payer organizations, provider systems, or healthcare technology environments.
- Minimum of 4+ years of experience with primary and secondary code editing frameworks.
- Deep expertise in health plan payment policy, claims editing, and reimbursement methodologies.
- Strong understanding of payer-provider dynamics, utilization management, and payment integrity programs.
- Experience in affordability initiatives, medical policy development, or claims operations is highly valued.
- Strong communication and presentation skills with the ability to simplify complex clinical concepts for diverse audiences.
- Proven ability to build trusted relationships with senior clinical and executive stakeholders.
- Strategic mindset with the ability to connect clinical, operational, and commercial priorities.
- Collaborative approach with experience working across sales, product, and client-facing teams.
- Willingness and ability to travel up to 40 percent.
Benefits:
- Competitive base salary range between $216,417 and $324,625 annually, based on experience, education, and location.
- Comprehensive total rewards package beyond base compensation.
- Opportunity to work in a highly innovative, AI-driven healthcare technology environment.
- High-impact leadership role influencing payer strategy, policy, and healthcare cost optimization.
- Collaborative, cross-functional culture spanning clinical, product, and commercial teams.
- Exposure to industry conferences, thought leadership opportunities, and executive-level engagement.
- Mission-driven environment focused on improving efficiency and reducing waste in healthcare systems.
- Commitment to diversity, inclusion, and equal opportunity employment.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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