Clinical Finance Case Management Consultant - RN
About The Position
The Clinical Finance Case Management Consultant – RN works in The Ohio State University’s Clinical Research Finance & Compliance (CRFC) Department, which supports the financial operations of oncology clinical trials. Reporting to the Director of Clinical Research Finance & Compliance, this role is a technical expert and knowledge leader who ensures compliance with clinical trial billing regulations, including Medicare guidelines, and supports accurate billing for OSUCCC–James patients participating in clinical trials. The consultant manages a portfolio of clinical trials and conducts comprehensive protocol reviews, known as Coverage Analyses, to classify procedures as Routine Care or Research-related and guide appropriate billing and coding. The role also performs ongoing reviews in response to protocol amendments and changes in applicable laws and regulations. It provides guidance to Revenue Cycle Specialists and Analysts, serves as a clinical subject matter expert within CRFC, and collaborates with Principal Investigators, the Clinical Trials Office, James Nursing, Revenue Cycle, and the Research Billing Office. The position requires independent work and high-level decision-making informed by scientific protocols, federal regulations, and clinical operations.
Requirements
- Bachelor’s degree or equivalent experience.
- Registered Nurse; must maintain RN licensure.
- Six years of relevant experience required.
- Ability to work independently and make high-level decisions informed by scientific protocols, federal regulations, and clinical operations.
Nice To Haves
- Eight to twelve years of relevant experience preferred.
- Master’s degree preferred.
- Experience with clinical trials preferred.
- Familiarity with Medicare billing regulations and hospital patient billing is a plus.
Responsibilities
- Manage a portfolio of clinical trials.
- Review study protocols through Coverage Analyses and classify procedures as Routine Care or Research-related to guide billing and coding.
- Perform ongoing reviews in response to protocol amendments or changes in applicable laws and regulations.
- Provide guidance to Revenue Cycle Specialists and Analysts.
- Serve as a clinical subject matter expert within the Clinical Research Finance & Compliance team.
- Collaborate with Principal Investigators, the Clinical Trials Office, James Nursing, Revenue Cycle, and the Research Billing Office.
- Support compliance with clinical trial billing regulations, including Medicare guidelines, and accurate billing for patients participating in clinical trials.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
