Pearl Health

Director, ACO Operations

Pearl Health

full-time

Posted on:

Location Type: Remote

Location: Massachusetts • New York • United States

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Salary

💰 $150,000 - $195,000 per year

Job Level

Lead

About the role

  • Lead the end-to-end Provider Submission process
  • Manage the Roster Management System (RMS) workflow
  • Provide strategic oversight and execution of Beneficiary Enhancement (BE) and Beneficiary Engagement Incentive (BEI) programs
  • Direct the development of educational materials and training programs
  • Oversee mandatory CMS operational tasks
  • Responsible for CMS-related knowledge management
  • Manage external resources and contractors during high-volume periods

Requirements

  • Orchestrate complex, multi-phase project lifecycles
  • 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
  • Deep technical knowledge of value-based care programs (eg. ACO REACH and/or MSSP) and regulations
  • Accountability for regulatory deadlines, with a proven track record of meeting multi-stakeholder filing requirements without constant oversight.
  • 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.
Benefits
  • Competitive benefits package. More on our careers page.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
project managementdata managementvalue-based care programsregulatory compliancedata workflow optimizationprovider submissionsroster management systemeducational material developmenttraining program developmentknowledge management
Soft skills
strategic oversightleadershipaccountabilityproblem-solvingcommunicationcollaborationproactive identification of issuesmulti-stakeholder managementadaptabilityattention to detail