The Health Care Administrator I, under the direction of the Director, Clinical Research Finance, provides specialized analytical evaluations of clinical research studies to support the joint mission between the University of Illinois Hospital & Health Sciences System (UI Health) and the Office of the Vice Chancellor for Research (OVCR) to maintain a compliant clinical trial billing program. Primary responsibilities include the performance of a comprehensive Coverage Analysis/itemized budget review on clinical research protocols with billable services in accordance with Medicare's Clinical Trial Policy (NCD 310.1) as well as medical association guidelines, national and local coverage determinations, professional practice guidelines, and UI Health applicable research billing policies. Evaluates clinical trial budgets to ensure procedural costs reflects defensible fair market pricing guidelines and UI Health research fee schedules. The Health Care Administrator I establishes and maintains cooperative and mutually supportive working relationships with UI Health faculty, administrators, research staff, the OVCR, and external research sponsors. Assignments require strong autonomous decision making and the ability to be flexible and prioritize within an ever-changing, service-oriented environment. Ensures that activities are carried out in accordance with established timeliness and specifications? coordinates reviews with the OVCR and Principal Investigator/designee in order to minimize clinical trial activation delays. Supports the Clinical Research Finance Office (CRFO) intra/interdepartmental operational requirements and may meet with key stakeholders across the clinical research revenue cycle to develop plans for the continued advancement of a compliant clinical trial billing program.

Proactively reviews and analyzes new clinical trials submitted to UIC IRB to make determinations necessitating a coverage analysis based on UI Health criteria for billable services. Initiates the coverage analysis process with the principal investigator/research staff and serves as a resource to provide ongoing consultation and education in keeping with current CMS, federal, local regulations/guidelines, and institutional policies applicable to research billing compliance. Revises existing coverage analyses when necessary due to protocol/contract revisions. Utilizes established UI Health Coverage Analysis matrixes and processes to document coverage analysis determinations completely and effectively.
Conducts parallel reviews of associated clinical trial budgets to confirm adequate reflections of procedural costs which may include research specific institutional fees. Works collaboratively with research staff and OVCR representatives to ensure applicable study documents, clinical trial agreements/federal awards are in concurrence with the coverage analysis/itemized budget. Makes appropriate edit recommendations to ensure reconciliation when necessary. Participates in the development of process improvement/quality assurance initiatives which support a compliant research billing program and enhance the performance of the Revenue Cycle, Clinical Research Finance. Maintains knowledge of current research related regulations and policies including CMS, FDA, OHRP, NIH, UI Health, and UIC. Assists in identifying CRFO operational and clinical research financial metrics and provides appropriate interpretation and application of data. Conduct special departmental projects and participate in the development of policies/SOPS supporting a clinical trial billing program. Other duties as assigned

Job Description Disclaimer This job description reflects the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.
Nothing restricts management’s right to assign or reassign duties and responsibilities to this job at any time.