Medicare Researcher; Remote Eligible
Washington, Tazewell County, Illinois, 61571, USA
Listed on 2026-09-20
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Healthcare
Data Scientist
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.
Mathematica is searching for professionals with experience designing and delivering real-world data analytics. This individual will leadthe 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 ofpay-for-performance, episode-based bundled payment, and total-cost-of-care shared savings models, with a particular focus on creating innovative approaches topayment 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
- 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
- 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…
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