General Manager, Medicare Advantage

Who we are...

Pearl Health is restoring the independence and joy of practicing medicine for doctors in the United States. Our healthcare system has burdened our doctors with too much process, while removing them from what they do best: caring for those we love most. We launched Pearl Health because we believe primary care providers, armed with the proper tools and resources, can have an outsized impact in achieving high-quality, affordable healthcare. We foresee a shift to an increasingly value-based future where physicians and provider groups will participate in the value they create for the healthcare system and will increasingly require proper tooling, information systems, capital support, and technology to succeed in these models.

We are a team of physicians (Groups), practice-enablement experts (VillageMD, Steward, Stellar), technologists (athenahealth, TrialSpark, Flatiron Health) and health plan leaders (Oscar, Clover, Centivo) who believe that primary care providers (PCPs) are the key to America’s future health.  Today, we support over 800 providers in value-based Medicare models, managing over $700M of Medicare benchmark risk in partnership with the physicians of the Pearl Network. To date, we have raised ~$100M to deliver on the next chapter of technology-enabled value-based care. Our investors include Andreessen Horowitz, AlleyCorp, and SVAngels.

What we hope you can do…

We are seeking an exceptional healthcare executive who is eager to help us build our second line of business. Your core focus will be driving the expansion of our value-based primary care offering to Medicare Advantage patients by helping design and execute our strategy to establish value-based partnerships with Medicare Advantage plans, thereby consolidating our offering to providers across Medicare. 

You will work collaboratively across our Product, Growth, and Operational teams to help us land 1-3 key partnerships for performance year 2024, expanding Pearl into a new line of business alongside our traditional Medicare book. Post-deal execution, we are seeking someone who can manage ongoing critical relationships with key leaders at our MA plan partners, and inform our launch strategy (and ongoing iterations), ensuring our offerings meet the necessary requirements for success. We are looking for someone who has a strong understanding and vision for how Pearl and our provider partners can succeed in value-based Medicare Advantage.

This position requires strategic thinking, project design, organizational development, understanding of actuarial and healthcare economics, and entrepreneurship. You should be eminently comfortable with the Medicare Advantage landscape, go-to-market concepts and playbooks, expansion of a book of business, and strategic thinking and collaboration with relevant teams to facilitate good decision making in a lean operating environment.  We expect a substantial aspect of this leadership position will involve leveraging a strong existing network to open doors and an ability to forge relationships with the most senior players in Medicare Advantage. 

What a General Manager, Medicare Advantage means to us...

• Play a key role in developing Pearl’s go-to-market strategy, value proposition, and pitch for MA Plans 
• Leverage existing rolodex to build a strong payor pipeline
• Articulate the vision for extending Pearl’s offering into a new line of business, in partnership with R&D, Data Science, and Growth.
• Build, manage, and execute against a prioritized payor prospect funnel, leveraging preexisting relationships with key targets to achieve growth goals
• Facilitate and contribute to a feedback loop based on learnings from payor targets, based on direct prospect reactions, synthesized insights, and other critical data points
• Serve as steward of sales process for payors, ensuring that key actions, deliverables, and analysis are delivered on a timely basis to achieve enterprise-focused sales objectives
• Demonstrate aptitude for relationship building and creating an exceptional experience for our providers.
• Design and improve the communication modules, outreach mechanisms, and rewards that further engagement with payor partners
• Identify local and market-specific insights; willingness to travel to assigned geographies for live prospecting
• Attend networking events, community events and conferences to grow relationships
• Work across the organization productively, to ensure successful implementation of this critical project

Who you are…

• 10+ years of experience in network contracting and development or other relevant payor leadership-facing field.  Experience with ACOs is a plus. 
• Excellent communication, interpersonal and presentation skills.
• You are rele