Clinical Trial Budget Analyst

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $97k - $145.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

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Sutter Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded Sutter Health was founded in 1996.

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

💰 Grant on 2016-11

Healthcare • Healthcare Insurance • Non-profit

Sutter Health is a not-for-profit health system serving Northern California, offering a wide range of healthcare services. It provides comprehensive primary and specialty care, including mental health, oncology, orthopedics, women's health, and more. The organization supports both in-person and virtual visits, ensuring accessibility to its services. Sutter Health is also involved in medical research, education, and offers various health plans, including Sutter Health Plus. It emphasizes innovative, compassionate care and maintains a network of hospitals, medical groups, and other health providers across Northern California.

📋 Description

• Determine whether a study is a qualifying clinical trial • Perform initial coverage analysis by reviewing protocol clinical services for federally compliant billing and reimbursement • Ensure complete submission of documents required to conduct coverage analysis and activate studies • Submit notification of participation letters to Noridian when needed • Determine and document billing support for clinical items by reviewing protocols, investigator brochures, sponsor budgets, sponsor contracts, consent templates, medical necessity justifications, and applicable payers • Apply federally required research-related claims modifications for insurance payment • Conduct final review and analysis of study documents to ensure harmonization • Interpret Medicare/Medicaid coverage decisions, national guidelines, and applicable clinical trial medical item and service rules • Support CPT/HCPCS billing determinations for clinical trial items and services • Apply local and national coverage determinations and third-party payer rules • Interface with Sutter Health research affiliates, administrative staff, principal investigators, essential partners, and clinical trial sponsors regarding reimbursement • Implement an integrated support function standardizing administrative and financial support for clinical trial billing compliance • Improve service to the Sutter Health research community and increase research compliance

🎯 Requirements

• Bachelors or equivalent education/experience • 5 years recent relevant experience • Knowledge of clinical research concepts, good clinical practices and regulatory compliance • Knowledge of Medicare benefit categories, statutory exclusions, national and local coverage determinations, and national medical practice guidelines • Knowledge of Food and Drug Administration investigational drug and device research • Knowledge of medical coding, protocol visit span allowances, protocol-specified clinical services, and clinical research financial activities and documentation • Knowledge of research protocols, internal budgets, sponsor contracts and budgets, and consent templates • Demonstrated written, oral, electronic communication, presentation, and interpersonal skills • Ability to use multiple technical systems • Ability to collaborate across revenue cycle, compliance, and research operations teams • Attention to detail • Analytical and computer skills, including proficiency in Microsoft Word, Outlook, and Excel • Ability to work independently and make complex and sensitive decisions • Outstanding organization skills to manage competing timetables and responsibilities • Demonstrated leadership skills, including team building and coaching/mentoring • Ability to build effective working partnerships with employees, peers, and leaders • Organizational and time management skills • Ability to prioritize multiple projects while delivering quality service and achieving business results • Tactical and analytical thinking and planning skills • Ability to develop plans, identify obstacles, and resolve operational issues • Skill in communicating and collaborating with Sutter Health essential partners and research institute personnel

🏖️ Benefits

• Comprehensive benefits package • Eligible positions include a comprehensive benefits package