Sana is building a health plan that feels simple on purpose, and this role is the “keep the engine clean and scaling” seat for claims. If you like leading teams, tightening workflows, and partnering cross-functionally to make claims faster, cleaner, and more accurate, this one’s for you.
About Sana Benefits
Sana is a remote-first health plan solution for small and midsize businesses, built around Sana Care (unlimited primary care + care navigation at no additional cost to members). Their mission is to make healthcare easy for members, employers, and brokers.
Schedule
- Full-time
- Remote (US-based)
- Distributed team, no return-to-office mandates
What You’ll Do
- Lead, coach, and develop a team of Claims and Appeals Processors to hit SLA and quality goals
- Own end-to-end claims operations: adjudication, appeals, QA, IDR negotiations, compliance, and dispute resolution
- Document SOPs, improve workflows, and lead automation/tooling initiatives to reduce friction and improve accuracy
- Manage customer support and provider escalations, partnering with CX, Network Ops, Sales, and Brokers
- Oversee rule-based payment logic and collaborate with Product/Engineering on the claims rules engine and systems (Jira, internal platforms, reporting tools)
- Build and maintain plan document infrastructure aligned with claims logic, network rules, and regulatory compliance
- Serve as internal claims SME, manage vendors, and support Stop Loss reporting/documentation needs
- Develop KPIs and dashboards to monitor performance, spot trends, and drive continuous improvement
- Partner on payment integrity and cost containment efforts to reduce waste and protect plan assets
- Drive cross-functional projects for system changes, rule updates, plan docs, and process improvements
What You Need
- 4+ years in health insurance claims processing (institutional + professional claims)
- Familiarity with coding standards and requirements (ICD, CPT/HCPCS, revenue codes) and regulatory compliance
- 2+ years managing teams in fast-paced, metrics-driven environments
- Strong organization and time management across multiple workflows and escalations
- Comfort building structure from ambiguity: SOPs, process design, system improvements
- Strong problem-solving instincts and willingness to dig into complex scenarios
- Excellent written and verbal communication for technical and non-technical audiences
- Analytical skills with spreadsheets; SQL is a plus
- Stop Loss and IDR experience is a plus (not required)
Benefits
- Fully remote, distributed team
- Flexible vacation (with a culture that uses it)
- Medical, dental, vision with 100% company-paid employee coverage
- 401k with company match
- FSA and HSA plans
- Paid parental leave
- Short/long-term disability + life insurance
- Stock options for all employees
- Transparent compensation + formal career development
- Paid one-month sabbatical after 5 years
- Home office stipend + ongoing learning budget
Compensation
- $93,000–$126,000/year (US-based remote; final offer varies by experience)
Happy Hunting,
~Two Chicks…