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Director, Cost of Care Performance

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Pearl Health

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Location:
United States , Seattle ▼

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Category:
Health and Beauty

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Contract Type:
Not provided

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Salary:

150000.00 - 195000.00 USD / Year
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Job Description:

At Pearl Health, you’ll help redefine how primary care succeeds in value-based care by driving meaningful improvements in total cost of care performance while maintaining high-quality, proactive patient care. As Director, Cost of Care Performance, you’ll own the total cost of care strategy—setting the roadmap, designing and leading programs, and driving execution to deliver measurable cost reduction and performance improvement in risk-based models.

Job Responsibility:

  • 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)
  • 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

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

Nice to have:

  • 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
What we offer:
  • Eligible for a discretionary performance bonus and equity options
  • competitive benefits package

Additional Information:

Job Posted:
February 20, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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