Sana’s vision is simple yet bold: make healthcare easy.
All of us can agree healthcare is simply too hard in the US. And our members feel that pain day in and day out. We aim to create an experience that simply feels easy when you need to access our healthcare system. If you need something, you know where to go to get it with care that is a click (or as few clicks as possible!) away.
What’s beautiful about a vision oriented toward “easy” is how it imparts a singular feeling. We instinctively know as humans when something is easy versus hard, even if we can’t explain why. We fight as a company to make an easy pathway available to all our members at every stage of their healthcare journey. If you feel passionate about delivering better healthcare to small businesses through a seamless care experience and affordable benefits, join us!
We’re looking for a Medical Director, Health Plan to own the clinical strategy of our health plan and ensure the care our members receive is both high quality and cost-effective. This role is the clinical authority on the payer side of the house — accountable for how coverage policies, utilization decisions, case management, pharmacy strategy, cost containment initiatives, and network design translate into real outcomes and sustainable unit economics. Reporting to the VP of Operations, you will be a key partner to Claims, Underwriting and Actuarial, Network Development, Finance, Revenue, and Product & Engineering. While separate from our Care Team, you will work closely with our Chief Medical Officer and virtual primary care team to ensure tight alignment between payer strategy and care delivery.
If you care deeply about fixing what’s broken in U.S. healthcare and want real ownership over how a modern health plan actually works, come build with us.
What you will do:
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 careBuild and lead a small clinician-led payer team responsible for in-house complex case management, high-cost claimant review, utilization management, and medical necessity reviewDrive strategy and implementation of cost containment initiatives, including clinical partnership management, tooling, and benefit designPartner 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 frictionPartner with Underwriting to assess clinical risk in quoting and pricing both prospective and renewing employer groupsSet and evolve evidence-based coverage guidelines, benefit design, and formulary policy aligned with high-value outcomesWork with Analytics to support medical economics, population health initiatives, and actionable insights for employer groupsWork 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 membersServe as a primary clinical voice in the design of Sana’s internal payer tools, coverage engines, UM workflows, and cost-transparency experiencesEvolve case management KPIs and build cost containment program reporting structures to measure efficacy and ROI
About you:
An MD or DO with board certificationLicensed to practice in Texas or willing to obtain licensure 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 plusDeeply comfortable making hard tradeoffs between cost, access, and clinical outcomesCredibility with both clinicians and operators, with the ability to explain clinical nuance to engineers and financial reality to physiciansStrong judgment under ambiguity and imperfect data; comfort working with analytics, SQL, and business intelligence tools like Tableau or Mode is a plusA builder’s mindset, with comfort improving existing tools while designing new processes and frameworks from the ground upComfort operating in a fast-moving, ambiguous startup environment where priorities evolve and roles are not rigidly definedClear and thoughtful communication, whether collaborating asynchronously, writing documentation, or working through complex problems liveDeep alignment with Sana’s mission and motivation to make healthcare work better for people and employersHumility, curiosity, and follow-through, earning trust through strong judgment, accountability, and collaboration
Benefits:
Full reimbursement for state licensure renewals and continuing education units (CEUs) — because keeping your credentials current shouldn't come out of your own pocketRemote company with a fully distributed team – no return-to-office mandatesFlexible vacation policy (and a culture of using it)Medical, dental, and vision insurance with 100% company-paid employee coverage401(k), FSA, and HSA plansPaid parental leaveShort and long-term disability, as well as life insuranceCompetitive stock options are offered to all employeesTransparent compensation & formal career development programsPaid one-month sabbatical after 5 yearsStipends for setting up your home office and an ongoing learning budgetDirect positive impact on members’ lives – wait until you see the positive feedback members share every day
