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Director, Care Management

Sana Benefits -
Remote

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Job Details

Full-time
$155,000 - $175,000 a year

Benefits

Stock options
Paid parental leave
Health savings account
Disability insurance
Health insurance
Dental insurance
Parental leave
Vision insurance
401(k) matching
Sabbatical
Life insurance

Qualifications

Cost management
Managed case managers
Doctor of Medicine
Formulary management
Pricing
Program design
Data visualization software proficiency
Clinical program implementation
Utilization review
Clinical program policy development
Finance
Startup experience
Tooling
Healthcare Administration
Business intelligence report generation
Public health setting experience
Process design
Patient advocacy
8 years
SQL
Small business experience
Team development
Key Performance Indicators
Collaboration with product development teams
Business intelligence tools
Policy & process development
Evidence-based practice
Health insurance knowledge
Team management
Nurse Practitioner (NP)

Full Job Description

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 Director, Care Management to lead our case management and utilization management functions making sure the care our members receive is high-quality, medically necessary, and at an appropriate cost. This role is for a clinical leader who understands care from the inside out and wants to build innovative solutions to work for Sana Health Plan members. You'll bring your patient advocacy lens to the payer side, influencing how coverage policies, utilization decisions, case management, and network design translate into real outcomes for the people we serve.

Reporting to the VP of Operations, you'll be a key cross-functional partner to Claims, Underwriting and Actuarial, Network Development, Finance, Revenue, and Product & Engineering. While distinct from our Sana Care Team, you'll work closely with our Chief Medical Officer and virtual primary care team to make sure payer strategy and care delivery stay tightly aligned. 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:

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

About you:

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

Our cash compensation amount for this role is targeted at $155,000 to $175,000 base + equity per year for all US-based remote locations. Final offer amounts are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above.

About Sana

Founded in 2017, Sana is a health plan solution built for small and midsize businesses — designed around our integrated primary care service, Sana Care. It’s the foundation of everything we build: ensuring members can easily access high-quality, affordable care while employers and brokers have the tools they need to manage company benefits with confidence.

We’ve been remote-first since day one, with a fully distributed team across the U.S. We value curiosity, ownership, and speed — and we build in the open, together. If you’re energized by solving complex, meaningful problems and want to help reshape how healthcare works from the inside out, we’d love to meet you.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Apply Now

Refine Your Search

implementations director jobs

Director, Care Management

Director, Business Applications

Regional Medical Director

Medical Director (Addiction Medicine) Beaverton Recovery Center

Director of Nursing (DON)

Clinical Services Program Director

Travel Director of Nursing

Traveling Director of Nursing (RN) - Skilled Nursing

Director of Nursing

PACE Medical Director, Jordan Valley Senior Care

Associate Director of Nursing

Director of Nursing (DON)

Director of Nursing - RN

BCBA - Board Certified Behavior Analyst - Clinical Director, Sign-on bonus up to $20,00

Clinical Director for Adults

Wellness Director, LPN

Rehab Director

Board Certified Behavior Analyst (BCBA) Clinical Director

Director of Inclusive Education

Clinical Director Board Certified Behavior Analyst (BCBA)

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