Consultant, Risk Adjustment Analytics

Avalere Health is seeking a Consultant to join its Policy Analytics and Modeling group.

Avalere Health is a strategic advisory company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington, D.C., the firm delivers actionable insights, business intelligence tools, and custom analytics for leaders in healthcare business and policy. Avalere’s experts span 200 staff drawn from Fortune 500 healthcare companies, the federal government (e.g., CMS, OMB, CBO, and the Congress), top consultancies, and nonprofits. The firm offers deep substance on the full range of healthcare business issues affecting the Fortune 500 healthcare companies. As an Inovalon company (Nasdaq: INOV), Avalere’s focus on strategy is supported by outstanding data analytics that generate unique insights and meaningful business improvement. Through events, publications, and interactive programs, Avalere insights are accessible to a broad range of customers.

Avalere Health is seeking a Consultant to join its Policy Analytics and Modeling group. The team provides analytic support and advisory services to a wide range of clients across the healthcare industry. Staff combine an in-depth understanding of quantitative methods with deep subject-matter expertise regarding healthcare policy and business issues.

This group focuses on a range of issues including:

  • Medicare & Medicaid payment policies and regulations
  • Risk Adjustment Modeling, Calibration, Simulation and Impact Analysis (Medicare, Medicaid, and ACA)
  • Alternative Payment Models (e.g., Medicare Oncology Care Model, Accountable Care Organizations, bundled payments)
  • Federal Budget forecasting and scoring models
  • Drug pricing reform
  • Health sector economic analysis and trends

Responsibilities

  • Conducting quantitative research on a diverse array of healthcare issues
  • Constructing and improving models to predict and understand policy implications, using claims data and pharmacy event data
  • Calibrating risk adjustment models, simulating alternatives to current risk adjustment models and analyzing the impact of risk adjustment models
  • Working independently and on collaborative teams with other analysts and experts, sometimes as the lead quantitative analyst on the project
  • Interpreting others’ analyses to assess, critique, or build on their findings
  • Understanding analyses and insights of other entities (e.g. CBO, OMB, CMS, MEDPAC, MACPAC)
  • Presenting quantitative results to both technical and non-technical audiences
  • All candidates to comply with all security policies/procedures

Skills, Experience, and Other Job-Related Requirements

Education Requirements

  • A graduate degree in public policy, public health, economics, or related field

Skill Requirements

Minimum Requirements

  • Familiarity with key data sources for healthcare analysis (e.g. Medicare Claims, Medicare Part D data, commercial claims data, Medical Expenditure Panel Survey (MEPS) data, or Medicare Current Beneficiary Survey (MCBS) data)
  • A strong interest in and knowledge of healthcare policy
  • Demonstrated analytic and quantitative skills
  • Excellent written and oral communication skills

Additional Skills and Competencies

  • The ability to interpret regulation and legislation to model impacts of changes on stakeholders
  • A willingness to learn complex issues relating to the health care delivery system
  • Initiative, working independently with minimal supervision
  • Ability to work in teams
  • Experience in managing multiple deadlines
  • A positive, professional, and solution-oriented attitude
  • Advanced experience with the Microsoft Office Suite, in particular Excel and Access. SAS/Stata experience strongly preferred, with opportunities to strengthen and develop skills

Experience Requirements

  • 4–6 years of relevant full-time work experience
  • Experience with healthcare-related quantitative analysis (e.g., risk adjustment calibration/modeling, forecasting models, or claims-based analysis)
  • Experience with one or more programming languages (e.g., SAS, Stata, SPSS, R)
  • Experience using SQL or similar programming languages to manipulate large data sets
*Avalere is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.