pearlhealth - Manager, ACO Operations
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Requirements
• We are looking for a motivated, data-driven professional who brings deep knowledge of value-based care operations and thrives in a collaborative, fast-paced environment where independent problem-solving and strategic thinking are essential. • 4+ years of progressive experience in healthcare operations, value-based care program management, or regulatory compliance, with demonstrated ability to independently manage complex initiatives and a proven record of success. • Understanding of the healthcare industry, with an emphasis on Medicare programs (eg. ACO REACH, MSSP, Medicare Advantage). • Highly analytical, with experience interpreting clinical quality data and financial performance metrics to develop actionable recommendations for ACO strategy and provider performance improvement. • Strong project leadership capabilities, with the ability to independently prioritize competing initiatives, allocate resources, and drive cross-functional execution with accountability for program-level outcomes. • Excellent communication and presentation skills, with the ability to clearly and effectively communicate complex ideas to diverse audiences. • Bachelor’s degree or equivalent work experience. • 🤝 Collaborate to Innovate: We believe the best solutions arise from intelligent teamwork. We trust the expertise of our teammates and pursue opportunities to learn and grow from each other. By embracing diverse perspectives and encouraging authenticity, we create and evangelize groundbreaking health solutions. • 🗣️ Trust Through Transparency: We prioritize transparency in all our interactions, ensuring that employees, patients, clinicians and partners have access to the information they need to make informed decisions. Integrity is at the core of how we operate, from building products to fostering relationships, and is crucial to our ability to communicate openly and gain trust. • ❤️ Serious Impact, Big Heart: We go above and beyond with our efforts to empower proactive, patient-centered care — and we celebrate every step forward. Humor and positivity fuel our creativity, strengthen relationships, and remind us to acknowledge the journey as much as the destination. • 2. Hiring Manager Interview: A deeper-dive conversation with your potential manager. • 3. Panel Interview: A round of meetings with teammates and cross-functional partners. • 4. Case Assignment/Presentation: A practical exercise inviting you to solve a real-world problem or relevant challenge. • 5. Executive Interview: Final conversation(s) with 1-2 of our leaders.
Responsibilities
• You will serve as the strategic operational and analytic engine for our ACO operations, exercising independent judgment on matters affecting ACO performance, regulatory compliance, and provider success. You will design and implement scalable systems and operational strategies for our growing ACOs. • Lead cross-functional initiatives to optimize the strategic and operational performance of Pearl Health’s Medicare ACOs, including developing alignment strategies, managing provider enrollment decisions, and directing CMS communications, recommending process improvements and policy changes. • Direct and oversee the CMS submission process, interpreting regulatory requirements and ensure accuracy, compliance, and adherence to all ACO program-related requirements on behalf of our provider partners. • Serve as Pearl Health’s representative in engagements with federal agencies, national advocacy organizations, and external partners, managing negotiations and communications that affect ACO program outcomes. • Develop, evaluate, and implement patient- and provider-facing programs, recommending programmatic changes based on performance data and regulatory developments to improve patient engagement and care outcomes. • Analyze program performance data and independently develop strategic recommendations for senior leadership on ACO operations, quality improvement, and total cost-of-care management.
Benefits
• The expected offer for this role includes the following components: • Base Salary Range: $90,000 - $130,000 per year. • Additional Compensation: This role is eligible for a discretionary performance bonus and equity options. • Benefits: We offer a competitive benefits package. More on our careers page. • Final compensation for this role will be determined by a variety of factors, including a candidate's relevant skills, experience, labor market conditions, and location. • AGENCY SUBMISSIONS • We are not currently working with contingency search firms. If a resume is submitted to any Pearl Health employee by a third party without a valid written and signed search agreement, it will become the property of Pearl Health and no fee will be paid, irrespective of whether the candidate is hired. • THE INTERVIEW PROCESS • While steps may vary by role, you can typically expect:
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