YCCI Manager, Clinical Research Billing Compliance

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$82,000.00 - $

137691WD

The Manager, Clinical Research Billing Compliance, leads and supports the day-to-day operations of clinical trial and research billing compliance activities. This role ensures accurate and compliant billing for research-related services by overseeing the Yale Center for Clinical Investigation (YCCI) Research Billing Compliance Team, consulting with the Financial Teams with YCCI’s Protocol Activation and Lifecycle Management (PALM) team, advising on development of billing plans, and ongoing monitoring.

This position is responsible for collaborating with all relevant departments within Yale, and Yale New Haven Health System (YNHHS) including YCCI-PALM, Yale clinical research study teams, YNHHS revenue cycle and research finance teams, etc.

Reporting to the Associate Director, Clinical Research Finance and Resource Utilization YCCI within the Yale School of Medicine, this position manages the development, implementation and monitoring of an effective clinical research billing compliance program, coordinating the clinical research billing reviews and monitoring efforts for clinical trials conducted at the Yale Medical School (including the School of Public Health). The position oversees an internal research billing compliance program and team;

the implementation of quality control measures to promote safety and compliance and the integration of QA with multiple review committees. A critical component of the role is to identify to the Directors any compliance concerns and recommend solutions to improve the overall operations, the safe and efficient conduct of clinical trials and educational and training opportunities for faculty and staff.

• Leads, manages and advises on the current change management program for improving the clinical research billing compliance program s includes working with current staff and vendors to develop, implement, monitor and report on outcomes of the updates and improvements being made to the current program. While the program will be in the change management process at time this position is filled, ongoing quality and change management will be expected for this role moving forward.

• Leads, manages, and advises on clinical research billing compliance matters as assigned. This includes serving as an expert resource regarding applicable laws, regulations, and standards governing clinical research billing conducted in the United States and other countries; providing advice and ensuring the efficient review, identification, and resolution of issues with a focus on customer service and compliance; and delivering relevant training.

• Leads, manages, and advises on clinical research billing compliance matters as assigned. This includes leading, managing, and advising on the following: clinical research billing compliance activities (e.g., Physician and Hospital Billing charge review, clinical research billing audits, Clinical Trial Management System (OnCore) patient billing plan set up and execution, research billing audits, etc.), systemic reviews to evaluate billing compliance to ensure compliance with all federal, state and local laws and regulations governing research billing compliance, responding to patient billing inquiries.

• Leads, manages, and advises on clinical trial billing operational matters and ensures operational efficiency and…