Medicare Researcher (Remote Eligible)

About the role

Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding using data science and analytics. Our work yields actionable information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica offers our employees competitive salaries and a comprehensive benefits package, as well as the advantages of being 100 percent employee owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in tandem with the company’s growth and financial strength. You will also be part of an independent, employee-owned firm that is able to define and further our mission, enhance our quality and accountability, and steadily grow our financial strength.

Responsibilities

• Mathematica is searching for professionals with experience designing and delivering real-world data analytics.
• This individual will lead the development and deployment of statistical models and operational processes using administrative claims and other data sources.
• Individuals with expertise in Medicare alternative payment models (APMs) will apply data analytics to support the implementation and refinement of pay-for-performance, episode-based bundled payment, and total-cost-of-care shared savings models, focusing on creating innovative approaches to payment incentives, developing and testing improvements to existing payment methodologies, constructing target prices, and reconciling provider fee-for-service payments against benchmarks.
• Participate in and provide oversight for tasks related to performance and payment calculations, production of provider-specific data and performance reports, and analytics to inform program monitoring and decision making.
• Develop and implement episode bundles.
• Test alternative approaches to attribution, risk adjustment, and peer grouping.
• Calculate financial benchmarks and reconciliation payments.
• Assess performance and refine performance scoring methods for model participants.
• Develop and produce provider feedback reports.
• Develop innovative approaches to monitoring compliance and conduct among APM participants.
• Participate actively and thoughtfully in multidisciplinary teams, drawing on 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, including 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.

Requirements

• 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