Clinical Research Nurse Hourly

Thomas Jefferson University • Philadelphia, PA

3d • Onsite

About The Position

Performs basic nursing skills, study coordination, and data management, with a central focus on subject recruitment and enrollment, consistency of study implementation, data integrity, and compliance with regulatory requirements and reporting. The role collects and documents participant clinical information, provides research-study education, obtains informed consent, and supports clinical-trial enrollment. It also works with consortium members and participating institutions to organize meetings, communicate, track progress, and distribute meeting minutes.

Additional duties include supporting research-team objectives, collecting and organizing data, adhering to protocol guidelines, and potentially collecting and processing specimen tissue for technical analysis. The posting also describes extensive case-management, utilization-review, medical-necessity, and appeals responsibilities, including applying criteria, reviewing documentation, coordinating with Physician Advisors and payors, maintaining records, and identifying denial trends. Patient-care coordination responsibilities include discharge planning, communication with patients and families, coordination with external providers, and recognizing and reporting abuse or neglect.

The position is based at 132 S 10th Street in Philadelphia, Pennsylvania, and has a rotating shift. Physical demands include lifting and carrying 40–50 pounds and frequent to continuous standing and walking; role-specific patient-care activities may include kneeling, bending, squatting, and performing CPR.

Requirements

• Associate’s degree in nursing or nursing diploma, or a bachelor’s degree in nursing is listed under minimum qualifications.
• At least 1 year of RN clinical experience in a health care setting.
• Three years of case-management, discharge-planning, or utilization-management experience required.
• Registered Nurse license in Pennsylvania.
• Knowledge of managed care and governmental and third-party payor reimbursement.
• Proficiency with InterQual and MCG criteria and their application.
• Strong interpersonal relationships.
• Ability to prioritize workload and collaborate with others to meet multiple deadlines.
• Effective oral and written communication skills.
• Ability to work in a team environment and document in electronic health records.
• Knowledge of medical, social, economic, and other services provided by departments or facilities, and ability to integrate multidisciplinary treatments for optimal patient care.
• Knowledge and understanding of legislation and regulatory bodies affecting healthcare practices.
• Ability to work constructively and collaboratively with a variety of individuals and groups.
• Ability to manage multiple concurrent objectives, projects, groups, or activities and make effective judgments about priorities and time allocation.
• Physical ability to lift and carry 40–50 pounds; frequent to continuous standing and walking. Patient-care tasks may include kneeling, bending, squatting, and CPR.

Nice To Haves

• Bachelor of Science in Nursing (BSN) preferred.
• Less than 1 year of research experience preferred.
• Certification in InterQual criteria.

Responsibilities

• Collect and document clinical information from study participants.
• Provide patient education regarding research studies.
• Obtain informed consent and support enrollment into clinical trials.
• Coordinate with consortium members and participating institutions; organize and schedule meetings, track progress, and record and distribute minutes.
• Collaborate with the research team and participate in identifying, developing, implementing, and evaluating goals and objectives.
• Support administration in adherence to protocol guidelines and collect and organize data for the research team.
• May collect and process specimen tissue for analysis by technical personnel.
• Refer cases to the Physician Advisor when further review or clarification is needed.
• Apply relevant medical-necessity criteria within 24 hours of admission to determine appropriate patient status.
• Complete retrospective clinical reviews for cases requiring third-party payor medical-necessity approval.
• Document medical-necessity criteria and level-of-care guideline subsets.
• Evaluate Level I medical-necessity appeal results and contract auditor retrospective denials for appeal appropriateness; refer cases for Physician Advisor input as needed.
• Follow Condition 44 downgrade procedures, including medical-record documentation and notification of the patient and Case Manager.
• Perform appeal processes, including IRO appeals and appeals coordinated with third-party payor formats and protocols.
• Research clinical aspects of cases to support appeals and refer cases lacking acute-level-of-care documentation to the Physician Advisor.
• Track Medicare admissions requiring review and document in medical records and work queues according to policy.
• Identify recurring denial and appeal issues and report them to the Manager.
• Follow organizational policies, third-party payer utilization-management workflows, and governmental payer processes.
• Use patient identifiers and an interdisciplinary approach to care planning and discharge coordination.
• Communicate discharge plans with patients, families, and multidisciplinary team members, and ensure patient information is transferred to external providers or facilities.
• Assess and anticipate discharge-planning needs to support a safe transition to the next level of care and involve patients, families, or guardians in decisions.
• Recognize signs of physical or emotional abuse or neglect and follow reporting policies and procedures.
• Adapt communication and patient support to developmental stage and patient needs, including those of neonates, infants, adolescents, adults, and geriatric patients.

Benefits

• Medical insurance, including prescription coverage
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability insurance
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits with access to group insurance rates and discounts
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service
• Medical insurance access for all colleagues, including those working less than part-time

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree