Clinical Research Coverage Analyst

Reposted Yesterday
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Chicago, IL, USA
In-Office
65K-90K Annually
Mid level
Edtech
The Role
Evaluate clinical trial protocols, consent forms, agreements, and budgets to create coverage analyses and billing grids. Build and audit study calendars in Oncore CTMS, ensure Medicare/CMS and regulatory billing compliance, communicate findings to investigators, train staff, and coordinate with research and finance stakeholders to support clinical trial initiation and workflows.
Summary Generated by Built In

Department

BSD OCR - CTMS Support Unit


About the Department

The Office of Clinical Research (OCR) is dedicated to supporting the infrastructure for the management and administration of clinical research at The University of Chicago as well as individual research programs with the goal of improving communication, consistency, and collaboration across the Biological Sciences Division and UChicago Medicine.
The mission of the OCR is to catalyze clinical research by providing expertise, resources, infrastructure, and systems that facilitate clinical research operations and enable collaboration across the enterprise while promoting compliance and human subject protection on behalf of our diverse community of patients and volunteers.


Job Summary

The job maintains regulatory compliance programs, including the interpretation of systems to identify areas of risk and may coordinate internal audits. With a moderate level of direction, participates in compliance documentation, compliance training, and compliance committee formation.
The Clinical Research Coverage Analyst is dedicated to ensuring billing compliance for clinical research and supports utilization of the Clinical Trial Management System (CTMS). This team member plays a crucial role in evaluating clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other pertinent study documents to generate a protocol calendar in the CTMS system and develop coverage analysis/billing grid.
The Analyst specifies which medical procedures and services may qualify as 'Routine Cost' and be billable to patient insurance, and which should be charged to the study. The Analyst is responsible for determining whether proposed clinical research studies meet the criteria for a Qualifying Clinical Trial as defined by CMS.
As a member of the Research Systems & Coverage Analysis (RSCA) Unit within the Office of Clinical Research, the Coverage Analyst works as part of a team to support and optimize clinical trial initiation and financial workflows, partnering closely with research teams and key stakeholders in the process.

Responsibilities

  • Coverage Analysis Creation: Review clinical trial protocols, budgets, contracts, and informed consent documents to determine billing compliance. Create detailed coverage analyses that outline the billing of clinical items and services required by research studies.

  • CTMS Build: Develop and audit study calendars within the Clinical Trial Management System, Oncore.

  • Regulatory Compliance: Ensure consistency in the application of Medicare and other applicable rules across studies and alignment of study documents with billing regulations.

  • Collaboration: Work collaboratively with key offices, including the Human Research Protection Program, the Clinical Trial Financial Group and research units, to harmonize regulatory and budgetary processes in clinical trials.

  • Communication: Communicate the results of coverage analyses to Principal Investigators and/or study teams, providing detailed explanations and addressing any questions or concerns.

  • Training and Development: Onboard and train new clinical research staff to ensure adherence to billing compliance procedures.

  • Additional Duties: Complete other duties as assigned by management to support the mission of the Office of Clinical Research.

  • Coordinates department or clinic compliance with a moderate level of guidance.

  • Prepares, completes and submits all compliance documentation on a routine basis. Coordinates compliance committee meetings.

  • Performs other related work as needed.


Minimum Qualifications

Education:

Minimum requirements include a college or university degree in related field.


Work Experience:

Minimum requirements include knowledge and skills developed through 2-5 years of work experience in a related job discipline.


Certifications:

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Preferred Qualifications

Experience:

  • Clinical research experience such as clinical research conduct, regulatory compliance, or related research activities.

  • Coverage analysis experience.

  • Clinical Trial Management System utilization.

Preferred Competencies

  • Ability to interpret research protocols, budgets, and consent forms to extrapolate billing/coverage information.

  • Ability to interpret NCCN guidelines.

  • Ability to audit work products and provide guidance and feedback.

  • Knowledge of relevant Federal and state regulations.

  • Ability to problem solve, leveraging information and expertise available.

  • Proficiency with computer software systems such as Clinical Trial Management System.

  • Strong organizational skills.

  • Ability to manage projects at various stages of completion.

  • Ability to manage high volume of workload and meet deadlines.

  • Demonstrated attention to detail.

Working Conditions

  • Fully Remote.

Application Documents

  • Resume (required)

  • Cover Letter (preferred)


When applying, the document(s) MUST be uploaded via the My Experience page, in the section titled Application Documents of the application.


Job Family

Legal & Regulatory Affairs


Role Impact

Individual Contributor


Scheduled Weekly Hours

40


Drug Test Required

No


Health Screen Required

No


Motor Vehicle Record Inquiry Required

No


Pay Rate Type

Salary


FLSA Status

Exempt


Pay Range

$65,000.00 - $90,000.00

The included pay rate or range represents the University’s good faith estimate of the possible compensation offer for this role at the time of posting.


Benefits Eligible

Yes

The University of Chicago offers a wide range of benefits programs and resources for eligible employees, including health, retirement, and paid time off. Information about the benefit offerings can be found in the Benefits Guidebook.


Posting Statement

The University of Chicago is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, or expression, national or ethnic origin, shared ancestry, age, status as an individual with a disability, military or veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination.

 

Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via Applicant Inquiry Form.

 

All offers of employment are contingent upon a background check that includes a review of conviction history.  A conviction does not automatically preclude University employment.  Rather, the University considers conviction information on a case-by-case basis and assesses the nature of the offense, the circumstances surrounding it, the proximity in time of the conviction, and its relevance to the position.

 

The University of Chicago's Annual Security & Fire Safety Report (Report) provides information about University offices and programs that provide safety support, crime and fire statistics, emergency response and communications plans, and other policies and information. The Report can be accessed online at: http://securityreport.uchicago.edu. Paper copies of the Report are available, upon request, from the University of Chicago Police Department, 850 E. 61st Street, Chicago, IL 60637.

Skills Required

  • College or university degree in a related field
  • 2-5 years of relevant work experience in clinical research, compliance, or related discipline
  • Experience creating coverage analyses and billing grids for clinical research
  • Experience using a Clinical Trial Management System (Oncore/CTMS)
  • Ability to interpret research protocols, informed consent forms, budgets, and clinical trial agreements for billing purposes
  • Knowledge of Medicare/CMS billing rules and relevant federal/state regulations
  • Experience auditing study calendars and providing feedback/guidance
  • Strong organizational skills, attention to detail, and ability to manage high volumes and deadlines
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The Company
Chicago, IL
Year Founded: 1890

What We Do

The University of Chicago is an urban research university that has driven new ways of thinking since 1890. Our commitment to rigorous inquiry and intellectual freedom draws pathbreaking scholars to our global campuses, where field-defining ideas are born that challenge and change the world. The University of Chicago has its main campus on Chicago's South Side and seven international campuses and centers throughout the world. Students can choose from 53 majors and 47 minors in the undergraduate College, with four divisions and seven professional schools for graduate study.

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