Role Description
The Principal Qualitative Researcher, Alternative Payment Model Implementation and Evaluation plays a pivotal role in the implementation and operation of healthcare programs and initiatives, the generation of actionable insights that inform decision-making for federal agencies such as the CMS Innovation Center (CMMI), and Commence’s growth in federal health research.
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Lead the design and execution of implementation, operations, and evaluation tasks for CMS/CMMI alternative payment models (APMs).
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Work closely with Commence’s data science and technology teams to bring advanced analytics to model implementation and evaluation.
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Drive greater efficiency and deeper insights.
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Translate model design documents and policy goals into operational methodologies and specifications using various data sources.
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Lead the development, refinement, and implementation of value-based care methodologies.
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Design and execute evaluations to estimate impact on healthcare spending, utilization, and quality.
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Partner with economists, data scientists, and engineers to conduct research and apply ML-based methods.
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Write methodology documents, evaluation reports, and briefings for CMMI model teams.
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Mentor junior researchers and analysts.
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Effectively manage teams, set priorities, coordinate tasks, and ensure high-quality reports and products are delivered on time and within budget.
Qualifications
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Ph.D. in economics, health services research, health policy, public health, or a related field with 9+ years of relevant experience; or a Master’s degree with 13+ years.
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Hands-on experience implementing and/or evaluating CMS/CMMI alternative payment models; experience with both is preferred.
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Working knowledge of at least two of the following: participant screening and monitoring, beneficiary attribution, payments and financial incentive design, quality measurement, comparison group design, quasi-experimental evaluation methods.
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Experience with Medicare and/or Medicaid administrative and claims data.
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Clear and concise writing for federal audiences; proposal-writing experience.
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Experience leading main tasks or projects and managing and mentoring staff.
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Must be authorized to work in the U.S. and able to obtain and maintain a CMS-required background investigation (public trust).
Requirements
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Experience with Databricks or other cloud analytics platforms and with Power BI, Tableau, or similar.
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Proficiency in SAS, R, Python, or SQL.
Work Environment/Physical Demands
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This is a remote position with occasional travel to the Baltimore/Washington, DC area for client meetings, orals, and team events.
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Regularly works in a climate-controlled environment.
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Must be able to sit, read, work on a computer, and watch a computer screen for extended periods of time.
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Occasionally required to stand, walk, use hands and fingers, kneel or crouch.
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Extended hours may be needed around proposal deadlines and key deliverables.