Lyric Jobs

Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated teams, and top technology help deliver more than $14 billion of annual savings to our many loyal and valued customers—including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric’s strong relationships as a trusted ally to customers resulted in recognition from KLAS as “true partner” and “excellent value for investment,” with a top score for overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai .

Description:

This position is responsible for establishing Lyric’s clinical content strategy that drives value for our customers and growth for the business. The primary focus will be setting the vision for the strategy to enhance the growth of the business through incremental content, modules, models, partners and programs that will bring maximum value to our customers and the payer market. The clinical content strategy will principally focus on the Payment Integrity space, but may include other value areas for payer and providers as well. A key responsibility of the role is to create a structure that continually ideates and iterates through the evaluation of new content areas.

Responsibilities:

• Establishes a clinical content strategy that will drive value for our customers and growth for Lyric. The clinical content strategy will principally focus on the Payment Integrity space, but could include other value areas for payer and providers as well.

• Creates a structure to ideate and initially evaluate and prioritize new areas of content and then drive the cross functional efforts to evaluate, validate and model the size of all new contentareas

• Develops a prioritized pipeline of new areas to be evaluated and establishes a process to quantify the value and size of the opportunity

• Evangelizes, both internally and externally, our strategy to increase value for our customers

• Collaborates cross-functionally within a matrixed organization, specifically partnering with Medical Director staff, Clinical Content Development, Sales, and Account Management teams to ideate and evangelize new editing concepts

• Validates the findings of Medical Director staff, Clinical Analysts, Analytics Advisors and addresses any internal and/or external questions in terms of the suitability of the content areas to drive value in regulated environments

• Assesses current competitor offerings and seeks opportunities for differentiation

• Contributes to solution positioning and messaging that articulates the value of our products and services to clients and differentiates our solutions across payer market segments

• Identifies vendor prospects to support new claims editing opportunities

• Demonstrates capability to remain current on claims editing and submissions trends impacting Payment Integrity

Requirements:

• AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist-Physician (CCS-P)

• 10+ years of relevant payer healthcare experience, preferably within the Payment Integrity area

• 5+ years experience investigating, researching, analyzing and communicating, results to various levels of leadership

• 10+ years active experience leading teams

• 5+ years experience understanding reimbursement and payment policies and methodologies, industry accepted claims editing citations and sources

Preferred Qualifications:

• Industry and payer market expert focused on the discovery and understanding of key healthcare issues, payer challenges, success criteria, medical cost and claim management trends as well as competitive product offerings and translating into new and innovative content solutions

• Experience in product development, clinical program management, healthcare technology, or management consulting

• Strong communication skills: verbal, written, and multi-media

• Strong interpersonal/relationship skills

• Personal, flexible, creative problem-solving style capabilities

• Ability to project high energy and passion for the process, while sustaining a patient persistence in achieving realistic goals

• Extreme ownership, bias to action, and know-how to succeed in ambiguity

• Demonstrated ability to lead in a matrixed environment

• Project/Program management skills

• Advanced clinical degree: MD, MSN, NP, DNP, or similar

*The US base salary range for this full-time position is:

$143,327.23 - $214,990.85

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. *

Diversity, Equity & Inclusion: At Lyric, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.