[Remote] Director, Operations at Pearl Health

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree required; advanced degree (MHA, MBA, MPH, or related) preferred
8+ years of experience in healthcare operations, value-based care, or health plan management
5+ years of leadership experience managing cross-functional teams and high-impact initiatives
Deep understanding of total cost of care, utilization management, and value-based care models
Proven success translating analytical insights into operational strategy and measurable results
Experience with Medicare and/or Medicaid programs, including CMS regulations and CMMI models
Demonstrated experience managing vendors and external partnerships to drive performance
Strong communication and stakeholder management skills across clinical, technical, and business teams

Responsibilities

Lead the operational strategy that powers Pearl’s value-based care success, connecting cross-functional teams, data, and execution to drive measurable impact on patient outcomes and provider performance
Drive the roadmap for operational programs and partnerships that reduce unnecessary spend and utilization and improve care delivery across Pearl’s provider network
Partner with Data Science, Product, and Customer Success to size and prioritize strategic opportunities that impact total cost of care
Translate insights into scalable operational tactics that improve patient outcomes, decrease wasteful spending, and enhance provider experience
Lead efforts to identify, investigate, and mitigate fraud, waste, and abuse (FWA) — ensuring our processes uphold integrity and quality across the network
Develop and manage strategic vendor partnerships that advance Pearl’s total cost of care and utilization management objectives
Partner with Product and Growth teams to transform provider feedback and market learnings into product enhancements and operational improvements
Collaborate with Customer Success to design, roll out, and optimize provider incentive and engagement programs
Champion provider education through clear communication materials, guides, and training sessions that support success in value-based care models

Skills

Pearl Health

Healthcare technology platform for providers

About Pearl Health

Pearl Health provides a platform designed to improve the efficiency and effectiveness of healthcare providers, including doctors and practice managers. The platform automates routine tasks, allowing providers to spend more time on patient care. It offers tools for tracking patient data and managing care teams, which helps providers gain transparency and credit for their work. Additionally, Pearl Health supports value-based care by enabling providers to monitor their performance through numerical data and graphs, helping them understand patient outcomes better. The platform also identifies at-risk patients, allowing for timely interventions. Pearl Health differentiates itself by focusing on technology that enhances care delivery and patient outcomes, while maintaining high customer satisfaction and retention. The company's goal is to empower healthcare providers to deliver better care through effective data management and support.

New York City, New YorkHeadquarters

2020Year Founded

$73MTotal Funding

DEBTCompany Stage

Enterprise Software, HealthcareIndustries

51-200Employees

Risks

Competition in value-based care threatens Pearl Health's market share.

Complex EHR integrations may lead to provider dissatisfaction.

Rapid expansion into 44 states may strain operational capabilities.

Differentiation

Pearl Health partners with Walgreens to enhance value-based primary care services.

The company integrates Vim's middleware for seamless EHR workflow enhancements.

Pearl Health's platform identifies at-risk patients for proactive care interventions.

Upsides

Partnerships with PraxisCare and Adaugeo expand access to value-based care.

Rising Medicare Advantage plans create opportunities for Pearl Health's solutions.

Increased telehealth adoption boosts demand for Pearl Health's integrated platform.

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