Medicare Researcher (Remote Eligible)

Mathematica; Ann Arbor (MI); On-site; USD 100,000 - 135,000; Full time

Job summary

Mathematica seeks professionals with experience designing and delivering real-world data analytics to lead development and deployment of statistical models and operational processes using Medicare data. This role focuses on pay-for-performance, episode-based bundled payment, and total-cost-of-care models, with emphasis on innovation in payment incentives and testing improvements.

In addition to technical expertise, the candidate will communicate findings to policymakers and program

Qualifications

• 4–8 years of experience in health policy, health research, or real-world analytics focusing on 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 related fields.
• Experience reviewing and interpreting federal regulations and translating regulations into business requirements and technical specifications.
• Experience analyzing Medicare Part A, Part B, Part D, enrollment, and other administrative data.
• Strong foundation in quantitative methods, including multivariate regression, time series analysis, and imputation.
• Broad understanding of Medicare value-based care and APMs.
• Excellent written and oral communication skills for diverse stakeholders.
• Ability to coordinate multidisciplinary teams and manage multiple priorities under deadlines.

Responsibilities

• Develop and deploy statistical models and operational processes using administrative claims and other data sources.
• Lead development and implementation of operational processes for APMs (bundled payment, shared savings, etc.).
• Develop proposals for new value-based care and payment reform projects.
• Author project reports, memos, technical assistance tools, issue briefs, and webinar presentations.
• Contribute to growth and institutional knowledge of staff in Medicare policy, APMs, and value-based care.

Skills

Quantitative methods

Communication skills

Team coordination

Analytical reasoning

Education

Master’s or PhD in data analytics/public health/public policy/economics or related

Job description

About Mathematica

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.

About Mathematica

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. Read more about our benefits here: Benefits at a Glance .

Primary Duties And 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. 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.

Role

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

Required Qualifications

• 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.

This position offers an anticipated base salary of $100,000 - $135,000 annually.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.

At Mathematica, we understand the importance of building relationships with colleagues. If you’re not located near one of our offices but would like opportunities to meet up with co-workers, we offer coworking spaces where available. Ask your Talent Acquisition partner for more information about this opportunity and whether it’s an option in your area.

Any offer of employment will be contingent upon passing a background check. Various federal agencies with whom we contract require that staff successfully undergo security clearance as a condition of working on the project. If you are assigned to such a project, you will be required to obtain the requisite security clearance. Additionally, if you participate in or complete the application process and are denied, Mathematica may choose to terminate your employment.

We take pride in our employees and in their commitment to excellence. We encourage staff to collaborate in developing creative solutions to difficult problems and to share the responsibility and enjoyment of carrying out complex projects. This collegial spirit has helped us earn our reputation for innovative and high-quality work.