Medicare Researcher (Remote Eligible)

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. In particular, we are looking for individuals with expertise in Medicare alternative payment models (APMs) who can 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, with a particular focus 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.

In this role, you will 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. Example projects include:

• 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

Duties of the position:

• 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