Medicare Researcher (Remote Eligible)

Mathematica, Inc.; Washington, Northern (IL, KY); Hybrid; USD 100,000 - 135,000; Full time

Job summary

Mathematica is expanding its team to design and deploy real-world data analytics for Medicare policy and value-based care initiatives. The role will lead statistical model development and operational processes using administrative claims, focusing on APMs to improve payment incentives and performance measurement.

You will participate in performance and payment calculations, produce provider-specific data and reports, and support program monitoring and decision making.

Qualifications

• 4–8 years of experience in health policy or health analytics.
• Master’s or doctoral degree or equivalent in relevant field.
• Experience interpreting federal regulations and translating to requirements.
• Experience analyzing Medicare Part A/B/Part D and enrollment data.
• Strong quantitative methods training: regression, time series, imputation.
• Broad understanding of Medicare value-based care and APMs.
• Excellent written and verbal communication for diverse stakeholders.
• Ability to coordinate multidisciplinary teams and work independently.
• Strong organizational skills with attention to deadlines.

Responsibilities

• Lead development of operational processes for APMs such as bundled payment, shared savings, or similar models.
• Develop performance reports and analytics for program monitoring and decision making.
• Contribute to proposals for new value-based care and other reform projects.
• Author project reports, memos, technical tools, and webinar presentations.
• Collaborate to grow staff expertise in Medicare policy, APMs, and value-based care.

Skills

Medicare data analysis

Health policy analytics

Multivariate regression

Time series analysis

Imputation

Policy translation

Stakeholder communication

Project coordination

Education

Master’s or doctoral degree or equivalent

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.

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 experiencedesigning and delivering real-world data analytics. This individual will leadthe development and deployment of statistical models and operational processesusing administrative claims and other data sources. In particular, we arelooking for individuals with expertise in Medicare alternative payment models (APMs)who can apply data analytics to support the implementation and refinement ofpay-for-performance, episode-based bundled payment, and total-cost-of-care sharedsavings models, with a particular focus on creating innovative approaches topayment incentives, developing and testing improvements to existing paymentmethodologies, constructing target prices, and reconciling providerfee-for-service payments against benchmarks.

In this role, you will participate in and provide oversightfor tasks related to performance and payment calculations, production of provider-specificdata and performance reports, and analytics to inform program monitoring anddecision 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.