Sana · 1 hour ago
Medical Director, Health Plan
United States
Full-time
Remote
Senior Level, Lead/Staff
$200K/yr - $250K/yr
8+ years expSana Benefits is a health plan solution aimed at making healthcare easy for small and midsize businesses. They are seeking a Medical Director to own the clinical strategy of their health plan, ensuring high-quality and cost-effective care for their members while collaborating with various teams to align payer strategy with care delivery.
Employee BenefitsHealth CareInsurance
Responsibilities
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
Qualification
Required
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
Company
Sana
Sana makes healthcare simpler, more affordable, and higher quality for small and midsize businesses.
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
$106.76MKey Investors
Gigafund
2022-06-15Series B· $60M
2021-10-25Series A· $20M
2020-09-09Series A· $20.8M
Leadership Team
Will Young
CEO & Co-founder
N
Nathan Hackley
Co-Founder
Recent News
Liquid 2 Ventures
2025-02-25
2023-12-22
The Information
2023-12-22
Company data provided by crunchbase