Clinical Trial Coverage Analyst

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location

Simpson Querrey Biomedical Research Center

Job Description

The Clinical Trial Coverage Analyst is an integral member of the Office of Clinical and Community Trials (OCCT). Under the direction of the Director, Research Operations and Conduct (ROC), the Clinical Trial Coverage Analyst is responsible for the development and review of Medicare Coverage Analysis (MCA) documents for qualifying clinical trials, understanding the budget and negotiation process and ensuring consistency and harmonization across research claims review, internal budget, funder budget, contract, and informed consent documents to uphold Research Institute and Hospital policies and clinical research billing compliance policy and guidance.

Essential Job Functions

• Reviews human subjects research studies to determine if they are qualified clinical trials pursuant to Medicare’s National Coverage Determination 310.1.
• Creates billing plan, including Medicare Coverage Analysis (MCA) documentation, in alignment with the Clinical Trial Agreement, budget, and informed consent.
• Determines billable services based on review of the Medicare’s Clinical Trial Policy (NCD 310.1), National Coverage Decisions (NCD’s), Local Coverage Decisions (LCD’s), Code of Federal Regulations (CFRs), state laws and professional practice guidelines.
• Work with Principal Investigators (PI) and research teams to provide accurate guidance for billing policies and procedures.
• Applies the appropriate CPT codes for potentially billable items in the MCA in order to assist in the management of claims review, as well as identifying items that are to be billed to the sponsor.
• Works closely with the Epic research billing team to assist in the creation of clinical trial management system and Epic billing grids.
• Review clinical trial amendments for changes that may impact the MCA. Make required changes as needed.
• Works closely with the Clinical Research Operations Manager, Clinical Trial Budget and Contract Managers, and other key team members to initiate the process for clinical trial determination and MCA review, and to ensure harmonization of the final coverage analysis with the final internal and negotiated budget, Clinical Trial Agreement (CTA) and IRB-approved informed consent form.
• Other job functions as assigned.
  
  

Knowledge, Skills And Abilities

• Bachelor’s Degree and 4 years of clinical trial experience OR a combination of 8 years of relevant work experience in Medicare coverage analysis creation, clinical research conduct, clinical research regulatory compliance, clinical research billing, and/or clinical research/trial budget and contract management.
• Understanding of study budgets, informed consent forms, and CTA cost language.
• Strong understanding of research billing compliance required. Ability to interpret research protocol information essential.
• Working knowledge of medical terminology.
• Ability to work independently and as a member of a team and follow through on assignments with minimal direction required.
• Demonstrated accuracy and precision, attention to detail, and exceptional organizational skills essential.
• Strong verbal and written communication skills required.
• Ability to manage large quantities of data in a manner which facilitates sharing of information.
• Ability to handle high volume of work with changing priorities and constant interruptions and establish priorities and deadlines required.
• Ability to prepare accurate documentation of events required.
• Ability to maintain confidential material and information required.
• Personal computer skills; functional experience with integrated software systems and proficient in Microsoft Office applications.
  
  

Education

Bachelor's Degree

Pay Range

$70,720.00-$115,627.20 Salary

At Lurie Children’s, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability
• Critical Illness, Accident and Hospital Indemnity coverage
• Tuition assistance
• Student loan servicing and support
• Adoption benefits
• Backup Childcare and Eldercare
• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
• Discount on services at Lurie Children’s facilities
• Discount purchasing program
  
  

There’s a Place for You with Us

At Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.

Lurie Children’s and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

Support email: [email protected]