
Medical Director, Health Plan
Sana
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $200,000 - $250,000 per year
Job Level
About the role
- Own Sana’s clinical strategy as a payer, defining how clinical standards, coverage policies, utilization decisions, and pharmacy strategy translate into high-quality, cost-effective care
- Build and lead a small clinician-led payer team responsible for in-house complex case management, high-cost claimant review, utilization management, and medical necessity review
- Drive strategy and implementation of cost containment initiatives, including clinical partnership management, tooling, and benefit design
- Partner closely with the operations team and our PBM partner to design evidence-based cost containment programs to bend the pharmacy cost curve without degrading outcomes or adherence, and limiting member friction
- Partner with Underwriting to assess clinical risk in quoting and pricing both prospective and renewing employer groups
- Set and evolve evidence-based coverage guidelines, benefit design, and formulary policy aligned with high-value outcomes
- Work with Analytics to support medical economics, population health initiatives, and actionable insights for employer groups
- Work with Network Operations, Care Navigation, Sana’s virtual care clinic, and Case Management to prioritize future contracting based on real gaps in care for Sana members
- Serve as a primary clinical voice in the design of Sana’s internal payer tools, coverage engines, UM workflows, and cost-transparency experiences
- Evolve case management KPIs and build cost containment program reporting structures to measure efficacy and ROI
Requirements
- An MD or DO with board certification
- 8+ years of experience spanning hands-on clinical care and payer-side, value-based, or population health work; prior startup or early-stage experience is a plus
- Deeply comfortable making hard tradeoffs between cost, access, and clinical outcomes
- Credibility with both clinicians and operators, with the ability to explain clinical nuance to engineers and financial reality to physicians
- Strong judgment under ambiguity and imperfect data; comfort working with analytics, SQL, and business intelligence tools like Tableau or Mode is a plus
- A builder’s mindset, with comfort improving existing tools while designing new processes and frameworks from the ground up
- Comfort operating in a fast-moving, ambiguous startup environment where priorities evolve and roles are not rigidly defined
- Clear and thoughtful communication, whether collaborating asynchronously, writing documentation, or working through complex problems live
- Deep alignment with Sana’s mission and motivation to make healthcare work better for people and employers
- Humility, curiosity, and follow-through, earning trust through strong judgment, accountability, and collaboration
Benefits
- Remote company with a fully distributed team – no return-to-office mandates
- Flexible vacation policy (and a culture of using it)
- Medical, dental, and vision insurance with 100% company-paid employee coverage
- 401(k), FSA, and HSA plans
- Paid parental leave
- Short and long-term disability, as well as life insurance
- Competitive stock options are offered to all employees
- Transparent compensation & formal career development programs
- Paid one-month sabbatical after 5 years
- Stipends for setting up your home office and an ongoing learning budget
- Direct positive impact on members’ lives – wait until you see the positive feedback members share every day
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical strategyutilization managementcase managementcost containmentevidence-based guidelinesmedical economicspopulation healthSQLbusiness intelligenceanalytics
Soft Skills
strong judgmentclear communicationcollaborationadaptabilitycredibilityhumilitycuriosityaccountabilityproblem-solvingleadership
Certifications
MDDOboard certification