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Seeking an inspired Sr Clinical Research Financial Analyst wanting to make a difference in Oncology Research. An ideal Sr Clinical Research Financial Analyst will be reliable, detail oriented, and a critical thinker. With working knowledge and experience with Payor Coverage Analysis, Budget Negotiations, and Study Builds, CTMS systems (Huron, Clinical Conductor), and identifying NCCD and Medicare guidelines for verification for services billable to insurances. Our team thrives to make our patients experience as pleasant as possible. We pride ourselves in our commitment to inspire great culture and relentless teamwork. Please join us if you share this passion!
Your pay and benefits are important components of your journey at Banner Health. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Banner Alzheimer's Institute (BAI) was established in 2006 as Banner Health's first Center of Excellence. Banner Health is one of the largest nonprofit health care systems in the United States. Our team is uniquely, passionately and strategically committed to ending Alzheimer's without losing another generation and to providing an unparalleled model of care for families facing this devastating disease. BAI is committed to improving people's lives through excellent patient care and advances that capitalize on the best biomedical research. We intend to make a transformational difference in Alzheimer's research and care.
POSITION SUMMARY This position provides pre-initiation research study evaluation including cost, coverage, and overall financial benefit analysis. Ensures analytical evaluations provide relevant and complete measures of cost, revenue, and billing projections and processing. Ensures regulatory compliance and financial coverage. Develops and maintains effective project relationships. Translates medical service priorities into effective research development activities and support allocations to ensure research leads to desired outcomes consistent with organizational goals.
CORE FUNCTIONS 1. Completes Cost and Coverage Analysis. Completes CCA for all BH research studies utilizing clinical skills, good clinical practices and knowledge of research and government regulations to evaluate each new study and determine appropriate coverage and billing requirements. Serves as a knowledgeable consultant to guide other personnel on the determinations of what patient care items and services are considered standard of care. Creates study budget for any and all research activity occurring within a BH facility to accurately determine relevant costs associated with all research activity. Negotiates study budget, with study Sponsor integrating Medicare Coverage rules and allowances into contract to ensure proper reimbursement and study billing requirements are met. Assesses study financial risk/benefit ratio.
2. Ensures regulatory compliance and financial coverage. Ensures compliance with required federal, state, funding source, and other applicable governing entities regarding regulations, laws, and statutes governing the scope of research activity. Accesses the Clinical Trials Management System to obtain names of human subjects to ensure that research related charges are billed appropriately. Acts as a liaison between finance departments, patient financial services, facility research directors and system reimbursement services for the purpose of communicating information regarding the National Coverage Decision for clinical trials and other federal research regulations. Serves as a resource and provides leadership assistance for research participants; asks questions regarding financial coverage issues to ensure service excellence.
3. Performs for cause and random patient account audits to ensure compliance.
4. Develops and maintains effective project relationships. Coordinates closely with Banner Research and University of Arizona staff in the study approval process; meets project timelines and department goals of optimal clinical, operational, financial and satisfaction outcomes. Interacts with sponsors, physicians, colleagues, facility administrators, facility CFOs and patient financial services to ensure effective communication and project coordination. Translates medical service priorities into effective research development activities and support allocations to ensure research leads to desired outcomes consistent with organizational goals. Leads and administers research projects by promoting research and collegiality between physician investigators, staff, facility administrators, and department heads. Leads, facilitates and or participates in task forces or councils to plan, implement and coordinate programs and/or activities for the organization.
5. This position is responsible for evaluating approximately 100 new study proposals per year with a research budget in excess of $3 million. Negotiates study budget, integrating Medicare Coverage rules and allowances into contract to ensure proper reimbursement and study billing requirements are met. Translates medical service priorities into effective research development activities and support allocations to ensure research leads to desired outcomes consistent with organizational goals.
Bachelor's degree in business or healthcare related field or an equivalent combination of education and experience.
Three to five years related experience working directly with clinical research charge review and billing, coverage analysis, and clinical trials budgeting and negotiations. Proven analytical and modeling skills. Working knowledge of computer spreadsheets and other computer applications.
Proven working knowledge of medical terminology and experience with CPT, HCPCS, ICD10 codes as they relate to clinical research billing. Experience utilizing a Clinical Trials Management System.
Additional related education and/or experience preferred.
Internal Number: R11040
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.