Clinical Research Coverage and Budget Analyst

Inova Office of Research is seeking a dedicated Clinical Research Coverage and Budget Analyst to join the team. This role will be full-time Monday - Friday, Hybrid Day shift.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Clinical Research Coverage and Budget Analyst Job Responsibilities:

• Analyze clinical trial documents to determine if research studies meet the requirements to be considered qualifying clinical trials according to federal guidelines
• Perform Coverage Analysis to determine which billable procedures are Routine Care, and thus, billable to Medicare and other third-party payers based on CMS and other federal guidelines, National/Local Coverage Determinations, and professional practice guidelines
• Collaborate with internal stakeholders to determine accurate Current Procedural Terminology (CPT) coding and other billable items/rules applicable to protocol requirements
• Review study documents to prepare a billing grid for all medical procedures and services required in a clinical research study by ensuring all billable services required by the research study are included in the study's billing grid
• Perform quality control reviews of approved billing grids, finalized budgets, informed consent forms, and clinical trial agreements to ensure harmonization across documents
• Review informed consent forms to ensure alignment with the final billing grid, budget (if applicable), and provide guidance on appropriate cost and compensation language
• Ensure consistency of the billing designations in the coverage analysis/billing grid with the informed consent form, the budget and the contract payment terms
• Analyze sponsors budget proposals to determine if the proposed funding is adequate to cover costs associated with trials. Ensure budget proposals meet Inova guidelines
• Negotiate study budgets with industry sponsors, Clinical Research Organizations (CROs) and other external entities.

Clinical Research Coverage and Budget Analyst Additional Requirements:

• Work schedule: 8-hour shift (Monday - Friday; Hybrid Day shift).
• Education: Bachelor degree in relevant field.
• Experience: Four (4) years' experience in coverage analysis and budget negotiations and /or clinical research.

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