Pearl Health · 2 weeks ago
Director, Cost of Care Performance
United States
Full-time
Remote
Director/Executive
$150K/yr - $195K/yr
8+ years expPearl Health is dedicated to empowering primary care providers and health systems in the shift to value-based care. As the Director of Cost of Care Performance, you will lead the strategy to improve total cost of care, manage operational programs, and drive execution for measurable performance improvements in risk-based models.
Health Care
Responsibilities
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
Qualification
Required
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
Preferred
Experience in healthcare technology, population health, or value-based enablement organizations
Background working with fraud, waste, and abuse (FWA) prevention programs or risk mitigation processes
Familiarity with analytics tools, provider performance dashboards, or data visualization platforms
Experience developing provider-facing materials, training, or education initiatives
Clinical training or experience (RN, NP, MD, or equivalent), particularly in contexts supporting value-based care or provider education
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.
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
Company data provided by crunchbase