The University of Illinois Hospital & Health Sciences System (UI HEALTH) is seeking an Director, Clinical Research Finance. The Director is responsible for the processes and functions associated with Clinical Research Revenue Cycle functions for research clinical trials. In addition to its direct responsibilities and collaboration within the UI Hospital and Clinics and broadly UI Health, the Director works closely with the Office of the Vice Chancellor for Research (OVCR), legal, compliance, fund accounting, the research community and other stakeholders to ensure the maintenance of seamless workflows in support of best practices that promote risk mitigation and research portfolio growth. The Director ensures effective system operations, effective and compliant revenue cycle operations within the research domain, participates in strategic planning initiatives, drives the implementation of plans, and oversees daily workflows for specific functional duties and areas of responsibility. The Director is a leader within the research community and clinical research revenue cycle.
Participates in strategic planning initiatives and drives effective execution of planning relevant to functional area(s).
In collaboration with the Associate Chief Financial Officer, Revenue Cycle, and the Office of the Vice Chancellor for Research (OVCR) establishes performance metrics for functional area of responsibility. Monitors performance in connection with these metrics and Clinical Research Revenue Cycle overall performance, proactively identifying opportunities for improvement and communicating these opportunities with appropriate leadership/areas.
Collaborates with other Revenue Cycle Directors and the OVCR on relevant activities and ensures interdependencies between specific area of functional oversight and other areas within Revenue Cycle have appropriate hand-offs. Proactively communicates to achieve seamless workflows and achievement of overall Revenue Cycle and Research objectives.
Develops, implements, and maintains functional specific administrative and operating policies and procedures ensuring consistency within other areas of Revenue Cycle and the OVCR. Leverages UI Health and UIC technology to ensure that automated solutions and applications support functional objectives. Remediates gaps where necessary.
Identifies, develops, and maintains reporting tools vital to sound management over the functional area(s) of responsibility. Effectively manages a departmental budget for functional area(s) of responsibility.
Develops and leads on-going education regarding compliant research budgeting and billing policies, regulations, and best practices.
Recruits for and guides the activities of direct reports ensuring optimization of human capital. Ensures the quality and accuracy of staff's and overall department's work. Drives employee developmental programming including annual performance evaluation, employee engagement, and talent management. Consistently promotes and supports a team approach to innovation in programs and problem solving both within functional area of responsibility and in collaboration with other Revenue Cycle and non-Revenue Cycle stakeholder departments.
Develops and maintains effective working relationships with vendors and peer managers both internal and external to the organization.
Stays abreast of industry changes impacting functional area and Clinical Research Revenue Cycle and identifies potential impact and required changes. Strives to promote best practices within functional area and within Clinical Research
Revenue Cycle. Ensures adherence to state and federal regulatory statutes as it pertains to Research and Revenue Cycle. Adheres to and supports Revenue Cycle departmental administrative policies.
Functional Specific Duties and Responsibilities:
Primary roles and responsibilities collectively comprise the Clinical Research Revenue Cycle function within Revenue Cycle.
Specific managerial oversight includes:
Responsible for overseeing day-to-day administrative operations of the Coverage, Budget Analysis and Research charge review units to ensure related functions are properly executed in a compliant and timely manner.
In collaboration with the OVCR, manages processes for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant study-related documents to determine whether proposed clinical research studies are a qualifying clinical trial as defined by Medicare Clinical Trial Policy
Creates, manages and oversees policies and procedures to determine what is billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs) and Local Coverage Decisions (LCDs), Code of Federal Regulations (CFRs), state laws, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region.
Develop and create Coverage Analysis billing justification matrixes to reflect which medical procedures may be billed to patient insurance and which should be billed to the study sponsor. Ensures coverage analyses for new studies and amendments to existing studies are appropriately and timely prepared and documented.
Establishes and maintain guidelines for development of study budgets incorporating clinical research defensible fair market value principles.
In collaboration with the OVCR, reviews and makes recommendations for and approves clinical study budgets and payment terms with research sponsors to ensure compliance with UI Health research pricing standards and capture of all costs.
Responsible for developing and administering an audit program; performs audits to assess the effectiveness of the research billing compliance processes and finds opportunities for improvement and/or develop corrective action plan in the event deficiencies are noted.
Collaborates with patient accounting and physician billing (revenue cycle) to identify and adjust incorrect and/or complex billing and reimbursement issues associated with research patient accounts. Finds opportunities for improvement and/or develop corrective action plan in the event deficiencies are noted.
Other duties, as assigned
Bachelor's degree in business, communications, nursing or any related field required.
A minimum of ten (10) years? previous work experience in the healthcare industry, preferably in an academic healthcare setting.
A minimum of five (5) years? previous work experience, preferably in an academic setting, is required in one of the following categories: clinical research finance, clinical research operations or billing and compliance of governmental payers.
A minimum of seven (7) years of Manager, Assistant/ Associate or Director level experience in a healthcare setting.
Experience working with Epic Systems is preferred.
Excellent verbal and written communication skills due to direct interaction with all levels of management; Strong time management and organizational skills; Strong problem solving and financial analytical skills.
Ability to interact professionally with all levels of employees. Improves technical skills through professional development efforts.
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