Medicare Researcher (Remote Eligible)

Summary

Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being through actionable insights. The Medicare Researcher will lead the development and deployment of statistical models and operational processes for Medicare alternative payment models, using administrative claims and other data sources. The role also oversees payment calculations, provider reporting, performance analytics, and the development of value-based care and payment reform initiatives.

Responsibilities

• Developing and implementing episode bundles
• Testing alternative approaches to attribution, risk adjustment, and peer grouping
• Calculating financial benchmarks and reconciliation payments
• Assessing performance and refining performance scoring methods for model participants
• Developing and producing provider feedback reports
• Developing innovative approaches to monitoring compliance and conduct among APM participants
• Participate actively and thoughtfully in multidisciplinary teams, drawing on your experience with Medicare data and policy, health services research methodologies, and APM development, implementation, and analysis
• Lead the development and implementation of operational processes for APMs such as bundled payment, shared savings, or similar models, which may include processes related to target price/benchmark determination, payment reconciliation calculations, technical assistance to providers, and analyses of model and provider performance
• Bring creative ideas to the development of proposals for new value-based care and other payment reform projects
• Author project reports, memos, technical assistance tools, issue briefs, and webinar presentations
• Contribute to the growth, expertise, and institutional knowledge of staff working in the areas of Medicare policy, APMs, and value-based care

Skills

• A Researcher-level candidate should bring 4-8 years of experience working in health policy, health research, or real-world analytics, with a substantial portion of that time dedicated to analyzing and supporting payer implementation of shared savings, bundled payment, or similar models
• Master's or doctoral degree or equivalent experience in data analytics, public health, public policy, economics, behavioral or social sciences, or other relevant disciplines
• Experience reviewing and interpreting federal regulations and translating regulations into business requirements and technical specifications
• Experience conducting analyses of Medicare Part A, Part B, Part D, enrollment, and other administrative data
• Strong foundation in quantitative methods, including experience with statistical techniques such as multivariate regression models, time series analysis, and imputation
• A broad understanding of Medicare's approach to value-based care and portfolio of APMs
• Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences, including program administrators and policymakers
• Demonstrated ability to coordinate the work of multidisciplinary teams, be accountable for delivering on ongoing activities, and work independently to solve complex problems
• Strong organizational skills and high level of attention to detail; flexibility to lead and manage multiple priorities, sometimes simultaneously, under deadlines

Qualifications

Must Haves

• A Researcher-level candidate should bring 4-8 years of experience working in health policy, health research, or real-world analytics, with a substantial portion of that time dedicated to analyzing and supporting payer implementation of shared savings, bundled payment, or similar models
• Master's or doctoral degree or equivalent experience in data analytics, public health, public policy, economics, behavioral or social sciences, or other relevant disciplines
• Experience reviewing and interpreting federal regulations and translating regulations into business requirements and technical specifications
• Experience conducting analyses of Medicare Part A, Part B, Part D, enrollment, and other administrative data
• Strong foundation in quantitative methods, including experience with statistical techniques such as multivariate regression models, time series analysis, and imputation
• A broad understanding of Medicare's approach to value-based care and portfolio of APMs
• Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences, including program administrators and policymakers
• Demonstrated ability to coordinate the work of multidisciplinary teams, be accountable for delivering on ongoing activities, and work independently to solve complex problems
• Strong organizational skills and high level of attention to detail; flexibility to lead and manage multiple priorities, sometimes simultaneously, under deadlines

Benefits

• Comprehensive benefits package
• 100 percent employee owned
• Financial benefits of ESOP holdings
• Remote eligible
• Coworking spaces where available