Director, Care Management

🕒 April 24

🇺🇸 United States – Remote

💵 $155k - $175k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

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Sana

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

☁️ SaaS

🤝 B2B

💰 $60M Series B on 2022-06

Healthcare Insurance • SaaS • B2B

Sana is a company providing modern health benefits tailored specifically for small businesses. The company offers comprehensive health plans which include medical, dental, and vision coverage, along with $0 healthcare options like virtual care, maternity, labs, and imaging services. Sana aims to simplify the management of health benefits, offering features like real-time employee management and transparent claims viewing. With a focus on affordability, businesses can save up to 20% by choosing Sana, with a high rate of renewal among clients. Their service includes a dedicated team of medical and benefits experts to assist members with guidance and in-network referrals. Sana emphasizes strong customer support with high satisfaction ratings, ensuring employees can keep their preferred providers without incurring out-of-network fees. The company prides itself on being a reliable and budget-friendly option for small businesses.

📋 Description

• Champion Sana's payer-side clinical strategy, ensuring that coverage policies, utilization decisions, and pharmacy guidelines are rooted in evidence-based practice and translate into seamless, high-quality care for every member • Build and lead a small clinician-led payer team responsible for in-house complex case management, utilization management, and high-cost claimant review • Drive strategy and implementation of cost containment initiatives, including clinical partnership management, tooling, and benefit design • Set and evolve evidence-based coverage guidelines, benefit design, and formulary policy aligned with high-value outcomes • Support the Operations team and our PBM partner to drive evidence-based programs to bend the pharmacy cost curve without degrading adherence, and limiting member friction • Partner with Underwriting to assess clinical risk in quoting and pricing both prospective and renewing employer groups • 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 program reporting structures to measure clinical efficacy and member outcomes

🎯 Requirements

• A valid license to practice as a NP, RN, PA, MD, DO and/or a Master’s in Healthcare Administration • 8+ years of experience spanning hands-on clinical care and payer-side population health work including case management and/or utilization management; 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

• Full sponsorship for state licensure renewals and continuing education units (CEUs) — because keeping your credentials current shouldn't come out of your own pocket • 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) with company match, 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