Overview

ORAU is seeking a Fully Remote, Senior Advisor- Medicare Advantage, SME to work with CMMI as an ORAU employee. This exciting work will last one or more years, and the successful candidate will become a temporary employee of ORAU assigned to the Centers for Medicare and Medicare Services Innovation Center (CMMI). This position is 8 hours per week.

CMMI was established by Congress in 2010 to identify ways to improve healthcare quality and reduce costs in the Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) programs. Following this charge, CMMI, through its models, initiatives and Congressionally-mandated demonstrations, has accelerated the shift from a health care system that pays for volume to one that pays for value. CMMI models are also researching and testing different approaches to innovative information technology systems which are essential to supporting this value transformation.

Responsibilities

The CMMI MA Strategy requires primary and secondary research to inform development of MA model concepts. Primary research requires analysis of MA benefit, claims, and financial data and other MA data sets. Secondary research requires a deep knowledge of leading MA research and applying that research to MA research and model concepts.

• Participate with staff in refining existing model and MA policies based on health services and MA research expertise.
• Provide substantive comments that help move forward the work on internal policy development documents for MA strategy, MA payment and beneficiary and plan choice design strategy, risk adjustment strategies, and future model concepts (variable frequency).
• Participate in strategy sessions with senior leadership on MA payment and beneficiary and plan choice design strategy.
• Participate and provide advice on MA risk adjustment strategy.
• Advise staff on latest research to inform MA visioning, existing and future models and CMMI strategy.
• Develop briefing papers on specific policy topics, such as MA payment and beneficiary and plan choice design, and other policy topics, TBD.
• Requires a mastery of Medicare Advantage models and policies. 

Qualifications

• PhD. in Health policy or related field.
• Significant experience in health services research and presentations on Medicare Advantage Organizations and Medicare policy issues relevant to Medicare Advantage programs and models, including analyses of their performance, impacts on market/competitive dynamics and health disparities, payment incentives, risk adjustment, quality, and beneficiary choice.