JOB OVERVIEW The Coverage Analyst Supervisor manages a team that performs Medicare Coverage Analysis (MCA) on clinical research protocols. The Coverage Analysis unit reviews a high volume of clinical research protocols, Informed Consent Forms (ICFs), Clinical Trial Agreements (CTAs), funding documents, and other relevant study-related documents to determine whether proposed clinical research studies are qualifying clinical trials as defined by Medicare Clinical Trial Policy. The team also determines what is billable after reviewing Medicare regulations, relevant National Coverage Decisions (NCDs) and Local Coverage Decisions (LCDs), Code of Federal Regulations (CFRs), state laws, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region. The team creates billing justification plans to reflect which medical procedures may be billed to patient insurance and which should be billed to the study sponsor. The office performs coverage analysis on investigator-initiated and industry-sponsored clinical research trials.
The Coverage Analyst Supervisor provides oversight of team processes and workflow, develops and maintains a thorough training program, and oversees a rigorous quality control program. The individual serves as a technical expert and adviser to the Manager. The Coverage Analyst Supervisor ensures coverage analyses are compliant with all relevant regulations and serves as the internal first-line contact for compliance issues. The individual is responsible for writing SOPs and ensuring analysts are adhering to policies and procedures. The Coverage Analyst Supervisor works collaboratively with Principal Investigators, project managers, study coordinators, budget analysts, and other research staff. The individual tracks key metrics, monitors timelines, and develops efficient workflows. The Coverage Analyst Supervisor evaluates business processes for operational and financial effectiveness. The individual is responsible for hiring and retaining staff, managing work assignments, and performance management.
The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and high-quality patient care. It is the only UC campus in the 10-campus system dedicated exclusively to the health sciences.