Director, Cost of Care Performance
$150k - $195k USD
The Opportunity
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. You’ll translate data-driven insights into high-impact initiatives, manage critical programs and partnerships, and drive reductions in unnecessary, inappropriate, or potentially fraudulent spend, ensuring Pearl’s total cost of care approach delivers sustainable financial and clinical results at scale.
Who We Are
Pearl Health is dedicated to empowering primary care providers, health systems, and physician-led networks to succeed in the shift to value-based care. Our platform delivers the technology, financial tools, and expert services that enable practices to provide more proactive, effective care to their Medicare patients, ultimately lowering costs and improving health outcomes.
Founded in 2020, we are a team of healthcare and technology innovators backed by premier investors like Andreessen Horowitz, Viking Global Investors, and AlleyCorp. We partner with thousands of providers across 44 states to build a more sustainable future for American healthcare.
What You'll Do
You’ll 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.
What You’ll Bring
You combine healthcare operational expertise with strategic systems thinking — equally comfortable diving into data, designing new programs, and leading teams through complex change.
Must-haves
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-haves
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.
This role might not be for you if
You prefer a highly structured environment where priorities rarely shift.
You’re looking for a role focused on oversight rather than hands-on execution and innovation.
You’re uncomfortable operating in a fast-evolving organization where collaboration and adaptability are key to success.
Our Values
🤝 Collaborate to Innovate: We believe the best solutions arise from intelligent teamwork. We trust the expertise of our teammates and pursue opportunities to learn and grow from each other. By embracing diverse perspectives and encouraging authenticity, we create and evangelize groundbreaking health solutions.
🗣️ Trust Through Transparency: We prioritize transparency in all our interactions, ensuring that employees, patients, clinicians, and partners have access to the information they need to make informed decisions. Integrity is at the core of how we operate.
❤️ Serious Impact, Big Heart: We go above and beyond to empower proactive, patient-centered care — and we celebrate every step forward. Humor and positivity fuel our creativity and strengthen relationships.
We are an Equal Opportunity Employer on a mission to improve lives. Our strength comes from the diverse backgrounds, experiences, and perspectives of our team. We welcome all candidates and are committed to a fair, inclusive hiring process free from discrimination.
What We Offer
The expected offer for this role includes the following components:
Base Salary Range: $150,000 - $195,000 per year
Additional Compensation: Eligible for a discretionary performance bonus and equity options
Benefits: We offer a competitive benefits package. More on our careers page.
Final compensation will be determined by a variety of factors, including relevant skills, experience, labor market conditions, and location.
Agency Submissions
We are not currently working with contingency search firms. If a resume is submitted to any Pearl Health employee by a third party without a valid written and signed search agreement, it will become the property of Pearl Health and no fee will be paid, irrespective of whether the candidate is hired.
The Interview Process
While steps may vary by role, you can typically expect:
Recruiter Screen: Introductory call to discuss background and motivation
Subject Matter Expert Interview: Deep-dive conversation with a core member of the team
Panel Interview: Meetings with teammates and cross-functional partners
Case Assignment / Presentation: Practical exercise solving a real-world challenge
Executive Interview: Final conversation(s) with 1–2 members of our leadership team