Clinical Research Budget and Coverage Analyst (RN)

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks
Pay Rate Type: Annual Salary
Location: Remote

Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates.
Min = $91,359.840
Mid = $118,767.792



Summary:

The role of the Clinical Research Budget and Coverage Analyst is to review clinical trial documents to determine if the study is a qualifying clinical trial pursuant to the Center for Medicare and Medicaid Services (CMS) policy, create/negotiate research budgets and generate a coverage analysis and billing plan according to payor rules, and then build an internal cost-based budget.

Responsibilities:

1. Reviews clinical trial documents to determine if the study is a qualifying clinical trial pursuant to the CMS National Coverage Determination (NCD) 310.1, also known as the Medicare Clinical Trial Policy, or otherwise approved by CMS.

2. Reviews clinical trial documents to determine study type and identifies all protocol required items and services.

3. Conducts and documents a coverage analysis and internal budget on all clinical research projects regardless of funding source (e.g., industry, government, or other identified funding source, or in the absence of an identified funding source).

• Determines clinical trial qualification.
• Determines appropriate payor source for clinical trial items and services incorporating appropriate Medicare coverage rules to ensure all charges associated with the research activities are billed to the appropriate parties.
• Using the coverage analysis, develops a complete internal cost-based budget for all items and services that cannot be billed to insurance and therefore need to be paid by a sponsor or other funding source to ensure costs associated with research activities are fully recovered.
• Coordinates as needed with appropriate ancillary departments regarding pricing.
• Provides identified study funding gaps to the Institutional Research Director in a timely manner.
• Updates budget and coverage analysis whenever there is a protocol or contract/budget amendment.

4. Provides coverage analysis to clinical research financial analyst to ensure proper payment from Sponsors, patients and/or third parties.

5. Provides guidance to clinical research regulatory coordinator regarding informed consent form (ICF) financial language.

6. Supports institutional development and implementation of research billing related policies, procedures and standard operating procedures (SOP), and subsequent standards for training.

7. Maintains current knowledge of applicable research related Medicare and Medicaid reimbursement guidelines, and payor requirements and apprise institutional organizational as indicated.

8. Maintains current knowledge of research coding regulations as they relate to Medicare Clinical Trial Policy and conduct training for the clinical research team as indicated.

9. Serves as an expert resource to clinical research team as it relates to Medicare and Medicaid policies and coverage.

10. Participates in continuing education to keep updated on new rules, regulations and revisions, as set forth by the Center for Medicare and Medicaid Services (CMS) and other entities regarding billing compliance.

11. Maintains professional growth through participation in continuing education programs.

12. Other duties as indicated.

Minimum Requirements:

• Bachelor's degree or higher in clinical health sciences preferred, such as Doctor of Pharmacy (Pharm.D) or nursing degree from an accredited four-year nursing school.

• Three years of recent work experience (or equivalent education) in clinical research or related fields, preferably in billing, coverage determinations and budgeting and/or understanding of research billing regulations.

• One year experience in basic accounting or finance functions preferred.

• Certification in SOCRA or ACRP (Certification should be achieved within 3 years in role)

Why Yuma Regional Medical Center?

Yuma Regional Medical Center (YRMC) is located in Yuma, AZ. Our purpose is building a healthier tomorrow. We strive by putting patients first as they are the center of every decision and action we take. YRMC is rooted in the community by living and breathing the dynamic nature of our region. Being committed to progress by constantly and consistently advancing healthcare, creating meaningful experiences and improving the lives of everyone around us.

Our Values

Bring Kindness | Achieve Together | Aspire For Better | Do The Right Thing | Lead With Optimism |

About Yuma, AZ

Named by the Guinness World Records as the Sunniest City on Earth with winters averaging temperatures of 70 degrees, sunny days and cooler nights.

Yuma, Arizona is a place to explore the great outdoors with hiking, jet skiing, boating and off-roading. Don't forget to soak up the sun at the great Colorado River or one of Yuma's many lakes.

Yuma is centrally located in Southwest Arizona, within a short drive to many popular attractions and destinations.

https://www.visityuma.com/

https://www.yumachamber.org/

Bring your skills to one of the sunniest places on earth - Yuma, AZ!

Physical Requirements and working conditions for this position will be provided to you up on interview.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!