Nurse Case Manager
Remote
Operations /
Full-time /
Remote
Our health system is broken, and it’s a huge problem. Costs are rising out of control while the patient experience gets worse. At Sana, we're passionate about fixing this problem by bringing accessible and affordable health plans to small and medium businesses. We've built an innovative team with top talent from across the health insurance and tech industries to create engaging, modern plans for our clients. This allows our customers to offer competitive benefits packages while paying an average of 20% less than traditional plans.
Our health system is broken, and it’s a huge problem. Costs are rising out of control while the patient experience gets worse. To make big improvements, we need innovative solutions that make great care available at affordable levels. At Sana, we are passionate about fixing this problem.
To do this, we have built a new kind of health plan from scratch for employers and their employees. Our customers can offer rich benefits to attract and retain top talent while paying less than traditional plans. Sana uses proprietary technology to cut out waste and a novel financing structure that gives companies money back when claims are low, saving up to 20% on total costs.
We are looking for a hard-working, empathetic person to join our Case Management team. We’re building a team of nurses to guide our members with complex and chronic care needs through the complicated healthcare system to ensure they receive the right care, in the right setting, at the right time. This is a remote position, but we do require that you have unencumbered licensure as a Registered Nurse in Texas, and are eligible for licensure in any US state.
What you will do
- Provide clinical navigation support for our internal health plan team to include but not limited to: condition education, care options, and planning, care compliance, medication adherence, shared decision support, and care coordination
- Proactive outreach engagement of high-risk, rising-risk, and gap-in-care members to help them best navigate their healthcare journey
- Manage the partnership with our external UM and RN Case Managers to ensure high quality, prompt utilization review, successful case management engagement, and high-value care navigation
- Act in the best interest of the member by being a health advocate and supporter in the member's healthcare journey
- Build relationships with clinical contacts at Sana’s partners to provide streamlined referral pathways for care navigation
- Assist with all post-op coordination of care and member support for patients who utilize our surgical care partners
- Help identify provider contracting opportunities for network development to improve member access
- Monitor and evaluate the effectiveness of care navigation and adjust as necessary utilizing clinical knowledge, evidence-based guidelines, and operational key performance indicators.
- Collaborate cross-functionally with Underwriting and Claims Operations to offer a clinical perspective on certain high-cost claimants.
About you
- Bachelor’s degree in a health-related field with at least 3 years of clinical experience. Case management experience preferred
- Previous Oncology experience or OCN certification is highly preferred
- Active and unencumbered licensure as a Registered Nurse in Texas. A compact license is preferred. Eligibility for licensure in any US state.
- Experienced in remote work
- Excellent clinical, organizational, and communication skills
- Entrepreneurial. Self-directed. Excited to build something from scratch
- Values-oriented. You care about making our healthcare system work better for people and business owners
- Gritty. You aren’t worried about getting your hands dirty and working hard when you need to
- Comfortable with change. We are a startup and need people who are ok doing things outside of their traditional job description
- Comfortable with modern web applications. We are building all of our software in-house and you will be a key constituent in its development
$80,000 - $85,000 a year
Our cash compensation amount for this role is targeted at $80,000-85,000 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.
About Sana
Sana is a modern health plan solution for small and medium businesses. We use a more efficient financing structure and integrated technology solutions to cut out wasteful spending and get members access to better quality care at lower cost. Founded in 2017, we are an experienced team of engineers, designers and health system operators. We have the financial backing of Silicon Valley venture firms and innovative reinsurance partners. If you are excited about building something new and being a part of fixing our broken healthcare system from the inside, please reach out!
