Clinical Trial Coverage Analysis Manager - Hybrid - 130220

UCSD's Office of Coverage Analysis Administration (OCAA) is dedicated to ensuring billing compliance for clinical research. A coverage analysis ties together the clinical trials protocol, budget, contract and informed consent to determine what is billable to insurance based on federal/state billing regulations including Medicare's National Coverage Decision (NCD) 310.1 as well as other third-party billing rules. It ensures consistent application of Medicare rules across studies, and consistent application of study documents.

Under the general direction of the Director, this position is responsible for managing and executing the day-to-day operations of OCAA related to Coverage Analyses (CAs) and supervising the OCAA staff. Incumbent will provide analyses and make independent contributions for planning and development of OCAA. This includes review of research protocols and assessment to determine the billable nature of items and services provided in the context of clinical research. Incumbent will provide training to the CA Analysts and Campus departments on the coverage analysis process, perform operational process review and implementation, review the work of the CA Analysts to ensure Quality Assurance (QA), perform website administration, update and modify Standard Operating Procedures (SOPs), continually review metrics and track productivity and timelines. Incumbent will focus efforts on operationalizing clinical research efforts for OCAA.

Incumbent may perform coverage analyses that include the development of the coverage analysis (CA) grid and billing justifications of varying complexity with information provided by the Principal Investigators (PIs), Study Teams, and other departments (i.e. HRPP, OCTA, and OCGA) in compliance with UCSD policies. Incumbent 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.

• Nine (9) years of related experience, education/training, OR a Bachelor's degree in related area plus five (5) years of related experience/training.

• Managerial experience and proven success in managing and leading a dynamic team of experienced and new analysts. Demonstrated knowledge of clinical research and interpreting and comprehending complex clinical research protocols, budget exhibits and informed consent forms.

• Possess excellent interpersonal skills including tact, diplomacy, flexibility, and professionalism in dealing with faculty, staff and industry representatives. Strong organization, communication, and customer service skills are required. Ability to maintain a professional manner in short fuse and time sensitive situations.

• Strong leadership skills with the ability to act independently and exercise sound judgment, with the acumen and sensitivity to identify those decisions and activities which require confidentiality and/or higher-level consultation and/or group collaboration.

• Strong supervisory skills and ability to direct others; Strong demonstrated ability to delegate, motivate, and evaluate employees. Demonstrated ability to recruit, train and supervise staff. Ability to establish and convey short- and long-term goals for assigned projects. Proven skill in promoting harmonious working relationships and working in a team environment. Experience in creating a positive team culture.

• Proven project management experience with the ability to participate in planning, organizing, analyzing, implementing and managing application of clinical research analyses involving multisite and priorities.

• Strong knowledge or Medicare coverage analyses, SB 37 and NCD 310.1 and other regulations relevant to clinical research.

• Demonstrated ability applying regulations to the billing of routine costs for clinical research.

• General knowledge of billing and coding for clinical care and research.

• Demonstrated knowledge and related experience to comprehend, interpret, and apply regulations to the billing of routine costs for clinical research.

• Employment is subject to a criminal background check.
• Must be willing and able to work occasional evenings and weekends based on business needs; travel to sites as necessary.

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health Sciences is comprised of our School of Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, The Herbert Wertheim School of Public Health and Human Longevity Science, and our Student Health and Well-Being Department. We have long been at the forefront of translational - or "bench-to-bedside" - research, transforming patient care through discovery and innovation leading to new drugs and technologies. Translational research is carried out every day in the hundreds of clinical trials of promising new therapies offered through UC San Diego Health, and in the drive of our researchers and clinician-scientists who are committed to having a significant impact on patient care. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

UC San Diego is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

For the University of California's Affirmative Action Policy please visit: https://policy.ucop.edu/doc/4010393/PPSM-20
For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

a. "Misconduct" means any violation of the policies or laws governing conduct at the applicant's previous place of employment, including, but not limited to, violations of policies or laws prohibiting sexual harassment, sexual assault, or other forms of harassment, discrimination, dishonesty, or unethical conduct, as defined by the employer. For reference, below are UC's policies addressing some forms of misconduct:

• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace