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Director, ACO Operations

United States, Seattle 150000.00 - 195000.00 USD / Year · Job Posted February 20, 2026
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Job Description

You will step into a high-stakes, mission-critical role where you own the operational engine that allows Pearl Health to scale its impact on value-based care. By mastering the complexities of CMS provider submissions and ACO operations, you will directly safeguard the integrity of our networks and enable compliant operations and access to enhanced benefits for our members. This is an invitation to build operational resilience from the ground up, transitioning a vital function from a 'heroic effort' to a sustainable, best-in-class program that scales with our growth.

Job Responsibility

  • 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

Requirements

  • 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

Nice to have

  • 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

What we offer

  • Eligible for a discretionary performance bonus and equity options
  • We offer a competitive benefits package

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