• 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 care • Build and lead a small clinician-led payer team responsible for in-house complex case management, high-cost claimant review, utilization management, and medical necessity review • Drive strategy and implementation of cost containment initiatives, including clinical partnership management, tooling, and benefit design • Partner 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 friction • Partner with Underwriting to assess clinical risk in quoting and pricing both prospective and renewing employer groups • Set and evolve evidence-based coverage guidelines, benefit design, and formulary policy aligned with high-value outcomes • 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 cost containment program reporting structures to measure efficacy and ROI