[Hiring] Senior Advisor - Payment Design @Oak Ridge Associated Universities

Role Description

ORAU seeks an experienced Senior Advisor with deep expertise in healthcare payment design and value‑based care to support the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). The Senior Advisor will advise on the research, development, and refinement of innovative payment models authorized under Section 1115A(a)(3) of the Social Security Act. This role provides high‑level subject matter expertise across multiple models.

The Senior Advisor will advise on model design, documentation, clearance materials, and when applicable data analysis to inform decisions across Medicaid and Medicare contexts.

Qualifications

• Experience designing APMs, including global budgets, capitation, shared savings/losses, risk corridors, and financial risk arrangements.
• Strong understanding of attribution methodologies for both total cost of care and episode‑based models.
• Working knowledge of benchmark development approaches and risk adjustment methods (clinical, demographic, social risk).
• Direct experience with Medicaid managed care rate development, capitation pricing, and HCBS payment methodologies.
• Understanding of Medicare payment systems, CMS innovation model structures, and related rate-setting principles.
• Background in pediatric payment models and Medicaid‑funded pediatric services.
• Experience with adult populations across both Medicaid and Medicare.
• Experience developing model memos, policy documents, clearance materials, and public‑facing technical materials.
• Experience conducting financial simulations, benchmarking analyses, data evaluation, and quantitative modeling.

Requirements

• Master’s degree in public health, health economics, or closely related field.
• 10+ years of relevant experience in healthcare payment model design, value‑based care, and Medicaid/Medicare programs.

Benefits

• Remote work opportunity.
• Competitive hourly salary of $89 - $95 per hour.