The Clinical Research Coverage Analyst isresponsible for performing a comprehensive Prospective Reimbursement Analysis on clinical research protocols to ensure accurate determinations of research patient care billing. The Clinical Research Coverage Analyst is responsible for providing assistance to departments in the development of budgets for clinical trials based on coverage determinations and educates departments regarding proper research patient care billing process. This position reports to the Associate Director - ORA Clinical Research.
Specific Duties & Responsibilities
Review and approve JHM proposed clinical study budgets for research patient care vs. routine care determinations via a Prospective Reimbursement Analysis.
Work closely with the School of Medicine Institutional Review Board to ensure research patient care costs are identified and informed consents are consistent with clinical research protocols and commercial contracts if applicable.
Participate in the Research Patient Care Billing Training Program for clinical research personnel to include PI, data-managers, research nurses, and research pharmacy.
Serve as a primary resource to provide JHM clinical research personnel recommendations and direction regarding protocol and budget development
Participate in creating Standard Operating Procedures for Research Patient Care to include Prospective Reimbursement Analysis, research patient care costs budgeting, patient registration, and research patient care billing
Effectively communicate results to departmental contact to ensure consensus regarding research patient care costs vs. routine of care
Maintain a comprehensive database of all Prospective Reimbursement Analysis grids, protocol and informed consent reviews and commercial contract budgets.
Serve as liaison to external auditing activities by the federal government, the University's external auditor, or third party insurers as related to research patient care billing.
Scope of Responsibility:
Knows the formal and informal departmental goals, standards, policies and procedures which may include some familiarity of other departments within the school/division. Is sensitive to the interrelationship of both people and functions within the department.
On a regular and continuous basis, exercises administrative judgment and assumes responsibility for decisions, consequences, and results having an impact on people, costs, and/or quality of service within the functional area.
Exchanges non-routine information using tact and persuasion as appropriate requiring good oral and written communication skills.
Bachelor's degree in biology, chemistry or related field required. Medicare coverage determination or significant related experience may substitute for education requirement.
5 years of experience in a clinical research environment
Special Knowledge, Skills, and Abilities
Thorough understanding of research patient care vs. routine of care treatment. Must be able to educate and advise clinical research personnel on the planning and coordination of clinical research protocols.
Knowledge of clinical research protocol management is required
Knowledge of clinical research budgeting is required
Exercises independent judgment in the resolution of issues regarding clinical research billing compliance
Must have excellent written and oral communication skills
Ability to work in a team and demonstrated interpersonal skills.
Classified Title: Clinical Research Coverage Analyst Working Title: Clinical Research Coverage Analyst Role/Level/Range: ATP/04/PD Starting Salary Range: $59,280 - $81,435; commensurate with experience Employee group: Full Time Schedule: Monday - Friday, 8:30am - 5:00pm; 37.5 hours/ week Exempt Status: Exempt Location: 32-MD:JH at 8 Market Place Department name: 10003802-SOM Admin Res Clinical Research Contract Personnel area: School of Medicine
The successful candidate(s) for this position will be subject to a pre-employment background check.
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