Towing my camper at 10,000ft.what do I need to worry about?

I always burn premium fuel when I tow through the Smokies, regardless of what the manufacturer recommends. The Smokies are mole hills compared to what you are talking about.

You may have to manually downshift the transmission. A transmission fluid temp monitor (maybe via a a OBD-II adapter and Torque app) is a good idea. If either the coolant or transmission fluid temps starts getting high, pull over some place safe and shut down for at least 30 minutes.