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Dana-Farber Cancer Institute · 6 hours ago

Senior Medicare Coverage Analyst

Brookline, MA

Full-time

Onsite

Mid, Senior Level

$78K/yr - $90K/yr

5+ years exp

Dana-Farber Cancer Institute is a leader in life-changing breakthroughs in cancer research and patient care. The Senior Medicare Coverage Analyst is responsible for reviewing clinical research protocols and creating coverage analyses, while also mentoring junior staff and serving as a subject matter expert on Medicare policies.

CommunitiesHealth CareHealth DiagnosticsHospitalNon ProfitOncology

Responsibilities

Mentors and trains junior MCA staff, provides second-level review of junior staff determinations

Creates coverage analysis grids for complex protocols

Serves as National and Local Coverage Determination (LCD and NCD) subject matter expert – disseminating changes to Medicare payor policy to other members of the MCA team

Triages and prioritizes coverage analysis workflow based on institutional need across disease centers – communicates MCA execution timelines to study teams and external stakeholders

Serves as the primary point of contact for urgent protocol amendments with budgetary and MCA impact, prioritizes and executes in narrow timelines

Independently interfaces with sponsors and sponsor representatives to resolve discrepancies in specific protocol assessments

Interfaces with study team and principal investigators prior to protocol submission to assist with MCA determinations/study design

Qualification

Medicare regulationsClinical trial life cycleClinical trials management systemBilling complianceResearch activity understandingCommunication skillsMentoring skills

Required

Bachelor's degree or RN credential

5 years of experience in Medicare coverage analysis

Experience with research activities in an academic medical center

Working with clinical trials management systems (CTMS)

Understanding of research activity in an academic medical center

Knowledge of billing compliance and Medicare regulations/policy, applicable federal, state, and local laws, rules, regulations and policies and institutional policies and standard operating procedures

Knowledge of clinical research budgeting and the clinical trial life cycle: study start-up through study closure

Ability to independently facilitate outreach/communication between study team and sponsor