New

Scientist, Senior

Acentra Health
paid time off
United States, Virginia, McLean
1600 Tysons Boulevard Suite 1000 (Show on map)
Sep 03, 2025
Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Scientist, Senior to join our growing team. Job Summary: Apply health services research and epidemiological methodologies to support Acentra Health's goals and objectives. Assist staff in investigative work, data collection, and data analysis to strengthen the output of our clinical decision-making tools and program evaluations. Responsibilities include analyzing complex healthcare claims and medical review data, supporting cooperative projects, validating findings, and contributing scientific and technical expertise in evaluating programs designed to measure the success of Acentra's initiatives. Accountabilities Project Design & Sampling: Support cooperative project design, including identification of study areas and calculation of appropriate sample sizes. HWDRG & Claims Review: Conduct analyses and reviews of Higher-Weighted Diagnosis Related Group (HWDRG) claims, ensuring diagnostic, procedural, and discharge information align with medical records and physician documentation. Support utilization review, DRG validation, and medical necessity determinations in accordance with CMS guidelines. Data Analysis & Risk Identification: Collaborate with CMS data contractors to access and analyze Medicare Part A claims and related datasets (e.g., CERT, CBRs, PEPPER). Apply quantitative methods to identify improper payment risks, patterns of upcoding, or other vulnerabilities impacting the Medicare Trust Fund. Improper Payment Reduction Strategy (IPRS): Contribute to the development of provider/service-specific selection strategies, statistical sampling, and evaluation methodologies that ensure validity and reliability of findings. Assist in developing measurable improvement goals and quality assurance activities. Education & Outreach: Assist in developing and implementing HWDRG education strategies, including one-on-one provider education and creation of feedback tools to reduce coding errors. Participate in provider and stakeholder education efforts to disseminate best practices while minimizing provider burden. Scientific Writing & Publications: Assist in the design and writing of feedback reports, evaluation mechanisms, and publishable documents that translate findings into actionable insights. Literature Review & Tools Development: Review relevant scientific and regulatory literature to inform the design of interventions, feedback mechanisms, and data collection instruments. Collaboration & Representation: Develop affiliations with health services researchers to strengthen Acentra's competitiveness for grants and visibility in scientific literature. Maintain effective professional relationships across internal teams, CMS, hospitals, providers, and other stakeholders. Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Qualifications Strong communication, analytical, and problem-solving skills. Proficiency with R, SAS, Python, and SQL highly desirable. Ability to collaborate effectively with team members across diverse clinical and experiential backgrounds. Knowledge of healthcare systems, Medicare claims, and regulatory guidelines. Familiarity with quality project methodologies and improper payment reduction strategies desirable. Education Master's degree in Epidemiology, Statistics, or Health Services Research required. Equivalent experience may be considered in lieu of formal education. #LI-RW1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Compensation The pay range for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! Visit us at https://careers.acentra.com/jobs EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Pay Range USD $95,040.00 - USD $118,800.00 /Yr.