Sana

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

Tech Stack

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