Manager of ACO Operations

Pearl HealthSeattle, New York City, Boston, or Remote

Remote Full-time $90K/yr - $130K/yr

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Experience Level

Manager

Qualifications

QualificationsProven experience in ACO operations management or a similar role, preferably within the healthcare industry. Strong analytical and problem-solving skills with a keen ability to interpret complex data. Outstanding communication and interpersonal skills, capable of working effectively across various teams and with external stakeholders. Experience with CMS regulations and Medicare programs. Bachelor's degree in a related field; advanced degrees or certifications are a plus.

About the job

Join Our Team

We are seeking an experienced ACO Operations Manager to become a key player in our ACO Strategy and Operations team. This role will position you as a subject matter expert and strategic advisor, focusing on our Medicare ACO programs. You will collaborate across various departments, including Customer Success, Product, Performance Operations, Clinical Strategy, and Data Science, to enhance the operational performance of our ACOs for our provider partners. The ideal candidate will possess strong strategic thinking skills, with the ability to assess complex operational issues and implement impactful initiatives across our expanding value-based care business.

About Pearl Health

Pearl Health is committed to empowering primary care providers, health systems, and physician-led networks in the transition to value-based care. Our innovative platform provides the necessary technology, financial resources, and expert services that enable healthcare practices to deliver proactive and effective care to Medicare patients, ultimately reducing costs and enhancing health outcomes.

Founded in 2020, our team of healthcare and technology pioneers is supported by leading investors, including Andreessen Horowitz, Viking Global Investors, and AlleyCorp. Together, we partner with thousands of healthcare providers across 44 states to shape a sustainable future for American healthcare.

Key Responsibilities

In this role, you will act as the strategic operational and analytical backbone for our ACO operations, making independent decisions that impact ACO performance, compliance with regulations, and provider success. You will be responsible for designing and executing scalable systems and operational strategies for our expanding ACOs.

Lead cross-functional initiatives aimed at optimizing the strategic and operational performance of Pearl Health’s Medicare ACOs by developing alignment strategies, managing provider enrollment processes, and directing CMS communications while suggesting process enhancements and policy modifications.
Oversee the CMS submission process, ensuring that all regulatory requirements are interpreted accurately and that compliance is maintained for all ACO program-related mandates on behalf of our provider partners.
Represent Pearl Health in engagements with federal agencies, national advocacy organizations, and external stakeholders, managing negotiations and communications that influence ACO program results.
Develop, assess, and implement programs for patients and providers, recommending adjustments based on performance metrics and regulatory changes to enhance patient engagement and care quality.
Analyze program performance data and independently evaluate key metrics to inform strategic decisions.

About Pearl Health

Pearl Health is at the forefront of transforming healthcare by equipping primary care providers, health systems, and physician-led networks with the tools necessary to thrive in a value-based care environment. Our cutting-edge platform integrates technology, financial solutions, and expert guidance to enable healthcare practices to deliver superior, cost-effective care for Medicare patients, thereby improving health outcomes and reducing expenses. Since our inception in 2020, we've established partnerships with numerous healthcare providers across 44 states, driving innovation and sustainability in American healthcare.

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Manager of ACO Operations

Pearl Health

Full-time|$90K/yr - $130K/yr|Remote|Seattle, New York City, Boston, or Remote

Join Our TeamWe are seeking an experienced ACO Operations Manager to become a key player in our ACO Strategy and Operations team. This role will position you as a subject matter expert and strategic advisor, focusing on our Medicare ACO programs. You will collaborate across various departments, including Customer Success, Product, Performance Operations, Clinical Strategy, and Data Science, to enhance the operational performance of our ACOs for our provider partners. The ideal candidate will possess strong strategic thinking skills, with the ability to assess complex operational issues and implement impactful initiatives across our expanding value-based care business.About Pearl HealthPearl Health is committed to empowering primary care providers, health systems, and physician-led networks in the transition to value-based care. Our innovative platform provides the necessary technology, financial resources, and expert services that enable healthcare practices to deliver proactive and effective care to Medicare patients, ultimately reducing costs and enhancing health outcomes.Founded in 2020, our team of healthcare and technology pioneers is supported by leading investors, including Andreessen Horowitz, Viking Global Investors, and AlleyCorp. Together, we partner with thousands of healthcare providers across 44 states to shape a sustainable future for American healthcare.Key ResponsibilitiesIn this role, you will act as the strategic operational and analytical backbone for our ACO operations, making independent decisions that impact ACO performance, compliance with regulations, and provider success. You will be responsible for designing and executing scalable systems and operational strategies for our expanding ACOs.Lead cross-functional initiatives aimed at optimizing the strategic and operational performance of Pearl Health’s Medicare ACOs by developing alignment strategies, managing provider enrollment processes, and directing CMS communications while suggesting process enhancements and policy modifications.Oversee the CMS submission process, ensuring that all regulatory requirements are interpreted accurately and that compliance is maintained for all ACO program-related mandates on behalf of our provider partners.Represent Pearl Health in engagements with federal agencies, national advocacy organizations, and external stakeholders, managing negotiations and communications that influence ACO program results.Develop, assess, and implement programs for patients and providers, recommending adjustments based on performance metrics and regulatory changes to enhance patient engagement and care quality.Analyze program performance data and independently evaluate key metrics to inform strategic decisions.

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