Revisions have been made to this job description to reflect the business needs effective 08/01/17.
UCSD Layoff from Career Appointment: Apply by 7/25/17 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.
UC San Diego career employees who have passed their trial period will have priority consideration for this position. Recruiters will begin to refer qualified internal applicants after the first 7 days of the job posting. Qualified external applicants may be referred to the hiring department, if a qualified pool of internal candidates is not identified and upon the request of the hiring manager.
RNs, LVNs and other clinical professionals are encouraged to apply!
The Sr. Clinical Trial Coverage Analyst will have familiarity with a clinical trial protocol and related regulatory documents in order to prepare clear documentation of who the payor will be for all medical procedures and services required in a clinical research project. The Coverage Analyst determines whether proposed clinical projects are a qualifying clinical trial as defined by CMS' Medicare Clinical Trial Policy and determines what is billable after reviewing the Medicare Benefits Policy manual, relevant National Coverage Decisions (NCDs) and Local Coverage Decisions (LCDs), Code of Federal Regulations (CFRs), state laws, and when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region.
The Coverage Analyst will perform coverage analyses that include the development of the coverage analysis (CA) grid and billing justifications of varying complexity with information in compliance with UCSD policies. The Coverage Analyst must be extremely comfortable working with numerous databases and electronic information, able to quickly read and comprehend large amounts of scientific, medical, and legal text. The analyst will have initiative, use good judgement and tact, interact with various internal and external customers with ease, and be highly resourceful and motivated in resolving clinical project issues in order to fulfill campus objectives. Candidates should have clinical or research experience, a strong understanding of protocol design and conduct, and a general understanding of applicable federal, state and local clinical research billing laws, regulations and policy.
The Coverage Analyst is an experienced professional who knows how to apply theory and put it into practice with in-depth understanding of the professional field; independently performs the full range of responsibilities within the function; possesses broad job knowledge; analyzes problems / issues of diverse scope and determines solutions.
The analyst must use skills as a seasoned, experienced research compliance professional with a full understanding of industry practices and organization policies / procedures to apply federal, state, and university regulations, policies, and guidelines, and promotes best practices. The analyst will interact frequently with investigators, persons in other organization departments and occasionally persons outside the University that will require the use of tact and independent judgment, knowledge of standards and best practices, and counseling to resolve a wide range of research compliance issues. The analyst is required to demonstrate good judgment in selecting methods and techniques for obtaining solutions. Errors or omissions may ultimately place research participant at undo risk and / or compromise the institution's assurance of regulatory compliance with the federal government.
Bachelor's Degree in clinical or science subject or related area and / or equivalent experience / training or at least 2 years of experience in clinical care, research or related field.
General knowledge of clinical care or clinical research and budget negotiations.
Ability to rapidly research online resources for information supporting billing rules and regulations. Ability to quickly read and comprehend large amounts of electronic text comprised of scientific, medical and legal language. Strong problem-solving and decision making skills.
Excellent interpersonal skills including tact, diplomacy, flexibility and professionalism in dealing with faculty, staff and industry representatives. Excellent communication skills both verbal and written.
Knowledge of medical terminology.
Advanced skills in using software applications such a
UC San Diego is an academic powerhouse and economic engine, recognized as one of the top 8 public universities by U.S. News and World Report. Innovation is central to who we are and what we do. Here, students learn that knowledge isn't just acquired in the classroom - life is their laboratory. UC San Diego's rich academic portfolio includes six undergraduate colleges, five academic divisions and ...five graduate and professional schools. The university's award-winning scholars are experts at the forefront of their fields with an impressive track record for achieving scientific, medical and technological breakthroughs.