3G (3rd Generation) Wireless, Analysis Skills, Billing, Clinical Assessment, Clinical Research, Clinical Support, Clinical Trial, Drug Development, Electronic Medical Records, Epic Systems, FDA Requirements, Healthcare Common Procedure Coding System (HCPCS), Medical Terminology, Medicare, Metrics, Operations Research, Pricing, Procedure Development, Quality Assurance, Reporting Dashboards, Research Skills, Standard Operating Procedures (SOP), Time Management
POSITION SUMMARY:
Under the general direction of the Director, Office of Clinical Research or designee, the Clinical Research Coverage Analyst will provide day-to-day support and guidance for clinical investigators and research staff when conducting Medicare coverage analysis determinations The position will also act as a liaison with all UMMS clinical partners, providing support to study team members to ensure electronic medical record clinical research charge review is conducted in accordance with applicable UMMS policies and procedures.
Responsibilities:
ESSENTIAL FUNCTIONS:
Coverage Analyses Support
- Responsible For ensuring that all coverage analyses are created in accordance with Medicare's clinical Trial Policy (NCD 310.1). Assists investigator and study team member with determination.
- Responsible For ensuring that all trials requiring QCT status are documented in OnCore according to institutional guidance.
- Advise research staff/study teams with the interpretation of related guidance, appropriate identification of procedures and their effects on research billing.
UMMHC/Clinical Liaison
- Provide support to clinical study teams for Epic research billing review.
- Coordinate with UMMHC and other clinical partners to obtain pricing for all needed services
- Monitor Epic Research Manager Dashboard to ensure timely response/review of clinical research charges
- Act as a liaison with UMMHC to resolve Epic billing review issues.
Quality Assurance
- Ensure consistency of the coverage analysis with the protocol, the informed consent form template, the budget and the contract payment terms
Education & Training
- Develop review and revise applicable training materials, job aids, SOPs and policies as assigned.
- Act as educational resource for study team members for clinical procedure pricing, QCT & Coverage Analysis questions
- Provide support for CCTS/OCR and ITCTMS training sessions as needed
Reporting
- Provide support to ensure that relevant CCTS/OCR metrics are captured accurately and in a timely manner
Qualifications:
REQUIRED QUALIFICATIONS:
- Bachelor's Level Degree or equivalent
- 3 - 5 years
- Experience in Clinical Research Operations, medical terminology
Additional Information:
PREFERRED QUALIFICATIONS:
HCPCS/CPT, FDA regulations, knowledge of Medicare Coverage decisions
**This is a hybrid position. The Coverage Analyst is expected to be flexible and available for onsite work based on the needs of the department**
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University of Massachusetts Medical School