Pearl Health · 2 weeks ago
Director, ACO Operations
United States
Full-time
Remote
Director/Executive
$150K/yr - $195K/yrPearl Health is dedicated to empowering primary care providers and health systems in the shift to value-based care. As the Director of ACO Operations, you will own the operational engine for CMS Program Operations, ensuring compliance and accuracy in provider submissions and regulatory requirements.
Health Care
Responsibilities
Lead the end-to-end Provider Submission process, serving as the accountable leader for roster accuracy and CMS deadlines during critical windows
Manage the Roster Management System (RMS) workflow, overseeing the transition of provider data into a streamlined, automated submission process
Provide strategic oversight and execution of Beneficiary Enhancement (BE) and Beneficiary Engagement Incentive (BEI) programs, ensuring all BE/BEI filings are accurate and compliant with CMS standards
Direct the development of educational materials and training programs for internal Pearl employees to socialize complex ACO regulatory requirements
Oversee mandatory CMS operational tasks, including CEHRT compliance, MSSP applications, and the coordination of beneficiary notification letters
Responsible for CMS-related knowledge management and partnership with the Program Owner and SMEs to modernize our program operations, documenting processes to eliminate "sausage-making" during peak cycles
Manage external resources and contractors during high-volume periods to maintain high quality-control standards under tight regulatory pressure
Qualification
Required
Orchestrate complex, multi-phase project lifecycles, ensuring seamless delivery within high-pressure environments and rigid deadlines
Maintain a zero-margin-for-error standard while overseeing the ingestion and processing of high-volume, mission-critical data sets
Proactively identify and resolve bottlenecks in data-intensive workflows to prevent downstream inaccuracies
Deep technical knowledge of value-based care programs (eg. ACO REACH and/or MSSP) and regulations, with the ability to translate complex CMS guidelines into actionable project plans
Accountability for regulatory deadlines, with a proven track record of meeting multi-stakeholder filing requirements without constant oversight
Preferred
Direct experience with CMS provider submissions, having successfully managed at least one full roster cycle for an ACO or similar value-based care entity
Experience implementing or managing a Roster Management System (RMS) or similar tool used to automate provider data flows
Background in CMS program management or policy, particularly experience with BEI programs and compliance frameworks
Prior leadership in a high-growth startup environment, where you have successfully transitioned tactical 'sprint' work into repeatable programmatic systems
Benefits
Eligible for a discretionary performance bonus and equity options
We offer a competitive benefits package.
Company
Pearl Health
Pearl Health provides an integrated platform to help primary care providers focus their attention on the patients who need it.
Founded in 2020
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
$95M2023-01-26Series B· $75M
2021-09-15Series A· $18M
2020-12-28Seed· $2M
Leadership Team
Jeff De Flavio
Executive Chairman and co-Founder
Matt Solnit
Chief Technology Officer
Recent News
2025-12-01
Business Wire
2025-10-21
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