Director, Clinical Research Billing

Job not on LinkedIn

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $94 - $125 / hour

⏰ Full Time

🔴 Lead

🧪 Clinical Research

👻 Ghost score 0%

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1885

🏥 Healthcare

Healthcare

Stanford Health Care is a major academic medical center and integrated hospital system delivering comprehensive clinical care, specialty services, and patient support. The organization operates hospitals, outpatient clinics and programs, offers clinical trials and telehealth (video visits), and provides patient-facing services such as a MyHealth patient portal, billing/insurance assistance, and resources for referring physicians, nurses and allied health professionals. It also engages with the community through donations, visitor services, and COVID-19 resources.

📋 Description

• Oversee the clinical research billing infrastructure, including coverage analysis, clinical research budgets, calendars, research charge review, research charge master, and sponsor invoicing • Ensure financial sustainability supporting sponsors and external collaborators • Develop and implement comprehensive clinical research billing compliance programs • Collaborate with Principal Investigators, study sponsors, study teams, finance/accounting, revenue cycle, internal audit, compliance, business office leaders, and clinic operational teams • Manage selection, scheduling, supervision, retention, evaluation, development, and mentoring of Clinical Research Billing staff • Lead department meetings, performance appraisals, feedback sessions, coaching, corrective counseling, and recognition activities • Facilitate team dynamics, team-building, and departmental process improvements • Lead the Clinical Research Billing Compliance Committee • Manage research billing and coverage analysis resources, including internal or vendor resources • Review study calendars, coverage analysis, and study expenses • Oversee post-award revenue cycle activities, research charge review, patient care billing for clinical trials, revenue capture and reimbursement trends, and financial forecasting • Develop policies, procedures, and workflows for clinical research billing • Deliver successful collection results against industry KPI and benchmark metrics • Partner with study teams, School of Medicine, Revenue Cycle, Compliance, and Internal Audit • Manage day-to-day department operations, schedules, priorities, standards, and activities • Contribute to and manage training programs for clinical research revenue cycle participants • Implement and monitor compliance components involving coverage analysis, Epic Research Billing Charge Review, and OnCore Clinical Trial Management System • Design, manage, and complete research billing compliance audits and use audit results to drive education • Respond to research billing non-compliance and collaborate with Internal Audit and Business Practices on deficiencies and process improvements • Maintain documentation and evidence of compliance for regulatory inspections and audits • Monitor regulatory, payer policy, industry, Epic, and OnCore changes and communicate impacts to executive leadership • Ensure adherence to internal controls and provide quality assurance for research billing processes • Identify billing and coding inaccuracies and address process gaps with interdisciplinary teams • Optimize information systems, data management, analysis, and Epic research-related workflows • Apply lean principles to process improvements • Partner with the School of Medicine to improve study activation through feasibility analysis, service identification/pricing, and pre-award budgeting • Ensure a safe and effective working environment and monitor safety, accreditation, regulatory, infection control, and staff competency requirements • Develop and deploy training and education materials with Revenue Cycle and School of Medicine training teams • Assist with department budgeting, expense management, staffing plans, schedules, and financial targets • Ensure coverage analysis fees are invoiced and paid timely • Analyze clinical trial billing profit and loss and guide charge description master and fee schedules • Provide financial status reports to study teams and investigators • Lead workflow and practice changes, Epic build/configuration input, change initiatives, and sustainable action plans • Build strategic relationships across teams, departments, and units • Identify and address developmental needs of self and staff

🎯 Requirements

• Bachelor’s Degree in Business, Finance, Health Care Administration, or a related field • Eight (8) years of progressive management experience in clinical research operations • At least five (5) years of progressive experience related to research finance/billing compliance • Advanced knowledge of CMS billing rules and regulations, including National Coverage Determinations, Local Coverage Determinations, and Clinical Trial Policy (NCD 310.1) • Strong understanding of the clinical research lifecycle, including coverage analysis, research charge review, budgeting, and sponsor invoicing • Advanced knowledge of CPT/HCPCS and healthcare terminology • Understanding of physician and hospital billing • Ability to communicate effectively with patients, physicians, family members, and co-workers • Leadership, critical thinking, self-direction, initiative, interpersonal, and oral/written communication skills • Ability to analyze data, identify issues and opportunities, draw conclusions, and develop appropriate solutions • Ability to work effectively in a fast-paced environment • Flexibility and adaptability • Excellent analytical and interpersonal skills • Sound judgment in applying and interpreting compliance policies, procedures, laws, rules, and regulations • Excellent problem-solving skills and technical knowledge related to financial and clinical research billing challenges • Demonstrates skills and competencies necessary to safely perform the assigned job through ongoing assessments and evaluations • Must maintain required credentials demonstrating competency per accrediting agency or department guidelines, as applicable • Must adopt and execute C-I-CARE standards for patients, families, and colleagues

🏖️ Benefits

• Equal opportunity and non-discrimination in employment • Consideration of qualified applicants with criminal convictions after individualized assessment • Employee patient and family experience framework and support