Penn State University
Payer Coverage Analyst - Clinical Trials Office
Penn State University, Hershey, Pennsylvania, United States, 17033
Payer Coverage Analyst - Clinical Trials Office
Join to apply for the
Payer Coverage Analyst - Clinical Trials Office
role at
Penn State University .
Application Instructions
CURRENT PENN STATE EMPLOYEE (faculty, staff, technical service, or student) – please log in to Workday and complete the internal application process. Do not apply here.
CURRENT PENN STATE STUDENT (not previously employed at the university) – please log in to Workday and complete the student application process. Do not apply here.
External applicants – click "Apply" and complete the application process.
Approval of remote and hybrid work is not guaranteed regardless of work location. For additional information on remote work at Penn State, see Notice to Out of State Applicants.
Position Specifics The Penn State College of Medicine Clinical Trials Office (COM CTO), in Hershey, PA, is dedicated to assisting in advancing clinical research through a commitment to excellence in support, compliance, and collaboration. We strive to ensure billing compliance, develop accurate and fair budgets, and provide robust support for the institution’s Clinical Research Management System (CRMS). Through its oversight of clinical research, the COM CTO ensures that studies are conducted with integrity, efficiency, and high standards, ultimately contributing to innovative healthcare solutions and improved patient outcomes.
The primary purpose of this position is to conduct payer coverage analyses by reviewing and evaluating oncology and non‑oncology clinical research protocols and related regulatory documents to prepare a billing plan for all billable items and services required in a clinical research project. This position is responsible for conducting the coverage analysis for all applicable studies in accordance with Medicare's Clinical Trial Policy (NCD 310.1) and other statutory requirements. The Payer Coverage Analyst will engage across the research team, post‑award team, patient financial services, Research Quality Assurance, the IRB, and other departments to ensure and facilitate billing compliance.
Primary Duties
Payer Coverage Analysis
Reviews trial‑related documents (protocol, consent, grant/trial agreement, budget, Investigator’s Brochure, etc.) for new and amended research protocols submitted to the Clinical Trials Office.
Identifies billable items and services based on the provided documents.
Interprets and applies knowledge of billing guidelines within national and local coverage determinations, compendia, and literature support to make billing determinations of items and services within a research protocol.
Discusses coverage analysis determinations with the research team and CT Clinic Research Budget Analysts to address potential concerns.
Budget Development Support
Drafts the Coverage Analysis Review and Study Billing Grid(s) to direct payer coverage analysis, identifying billable items and services, and assigning billing determinations.
Attends budget meetings to facilitate discussion with the study team related to billing determinations within a research protocol.
Reviews billing determinations with CT Clinic Research Budget Analysts to establish a research protocol budget.
Clinical Research Management System (CRMS) Study Design and Management
Assists with building clinical research studies into the CRMS by converting study protocols and negotiated budgets into a user-friendly interface to ensure billing compliance and proper management of study funds.
Provides user support throughout the life cycle of each trial, including updating studies in the CRMS based on protocol and/or coverage analysis.
Collaborates with clinical research budget analysts, patient financial services, study teams, and post‑award financial analysts to resolve research billing compliance issues.
Education and Training
Provides subject matter expertise to College of Medicine colleagues involved in pre‑award and post‑award processes.
Assists in interviewing, training, and mentoring CTO staff, including teaching best practices for payer coverage analysis of oncology and non‑oncology studies.
Engages in one‑on‑one meetings with faculty and research staff from other departments to provide in‑depth training and project‑specific guidance.
Assists in developing faculty and research staff education programs on specialized research administration topics and disseminates new knowledge through workshops and ad‑hoc groups.
Regulatory and Institutional Compliance
Completes the HRP‑903 Radiation Review Form and Ancillary Review for studies via CATS IRB, as applicable, collaborating with the Radiation Review Committee.
Completes the CTO Ancillary Review for studies via CATS IRB, as necessary.
Preferred Experience
ACRP or SoCRA certification
Clinical research study coordination experience
Clinical background (e.g., RN, LPN, EMT‑P, RT, pharmacist, etc.) strongly preferred
Professional Levels
Intermediate Professional – Performs Medicare Coverage Analysis on non‑oncology drug studies; may perform coverage analysis on device studies in close collaboration with a senior team member.
Advanced Professional – Provides Medicare Coverage Analysis on non‑oncology and cooperative group oncology studies independently; may perform coverage analysis on sponsored oncology studies with a senior team member.
Senior Professional – Provides Medicare Coverage Analysis on oncology and non‑oncology studies.
Principal Professional – Provides Medicare Coverage Analysis on oncology and non‑oncology studies.
Salary & Benefits Salary range: $51,000.00 – $115,100.00. Penn State provides a competitive benefits package, including comprehensive medical, dental, and vision coverage, robust retirement plans, generous paid time off, and a 75% tuition discount for employees and eligible family members.
Employment Requirements Successful background check in accordance with University policies is required. Applicants must be authorized to work in the U.S.; Penn State does not sponsor or take over sponsorship of a staff employment visa.
EEO Statement Penn State is an equal opportunity employer and is committed to providing employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. If you are unable to use our online application process due to an impairment or disability, please contact 814‑865‑1473.
#J-18808-Ljbffr
Payer Coverage Analyst - Clinical Trials Office
role at
Penn State University .
Application Instructions
CURRENT PENN STATE EMPLOYEE (faculty, staff, technical service, or student) – please log in to Workday and complete the internal application process. Do not apply here.
CURRENT PENN STATE STUDENT (not previously employed at the university) – please log in to Workday and complete the student application process. Do not apply here.
External applicants – click "Apply" and complete the application process.
Approval of remote and hybrid work is not guaranteed regardless of work location. For additional information on remote work at Penn State, see Notice to Out of State Applicants.
Position Specifics The Penn State College of Medicine Clinical Trials Office (COM CTO), in Hershey, PA, is dedicated to assisting in advancing clinical research through a commitment to excellence in support, compliance, and collaboration. We strive to ensure billing compliance, develop accurate and fair budgets, and provide robust support for the institution’s Clinical Research Management System (CRMS). Through its oversight of clinical research, the COM CTO ensures that studies are conducted with integrity, efficiency, and high standards, ultimately contributing to innovative healthcare solutions and improved patient outcomes.
The primary purpose of this position is to conduct payer coverage analyses by reviewing and evaluating oncology and non‑oncology clinical research protocols and related regulatory documents to prepare a billing plan for all billable items and services required in a clinical research project. This position is responsible for conducting the coverage analysis for all applicable studies in accordance with Medicare's Clinical Trial Policy (NCD 310.1) and other statutory requirements. The Payer Coverage Analyst will engage across the research team, post‑award team, patient financial services, Research Quality Assurance, the IRB, and other departments to ensure and facilitate billing compliance.
Primary Duties
Payer Coverage Analysis
Reviews trial‑related documents (protocol, consent, grant/trial agreement, budget, Investigator’s Brochure, etc.) for new and amended research protocols submitted to the Clinical Trials Office.
Identifies billable items and services based on the provided documents.
Interprets and applies knowledge of billing guidelines within national and local coverage determinations, compendia, and literature support to make billing determinations of items and services within a research protocol.
Discusses coverage analysis determinations with the research team and CT Clinic Research Budget Analysts to address potential concerns.
Budget Development Support
Drafts the Coverage Analysis Review and Study Billing Grid(s) to direct payer coverage analysis, identifying billable items and services, and assigning billing determinations.
Attends budget meetings to facilitate discussion with the study team related to billing determinations within a research protocol.
Reviews billing determinations with CT Clinic Research Budget Analysts to establish a research protocol budget.
Clinical Research Management System (CRMS) Study Design and Management
Assists with building clinical research studies into the CRMS by converting study protocols and negotiated budgets into a user-friendly interface to ensure billing compliance and proper management of study funds.
Provides user support throughout the life cycle of each trial, including updating studies in the CRMS based on protocol and/or coverage analysis.
Collaborates with clinical research budget analysts, patient financial services, study teams, and post‑award financial analysts to resolve research billing compliance issues.
Education and Training
Provides subject matter expertise to College of Medicine colleagues involved in pre‑award and post‑award processes.
Assists in interviewing, training, and mentoring CTO staff, including teaching best practices for payer coverage analysis of oncology and non‑oncology studies.
Engages in one‑on‑one meetings with faculty and research staff from other departments to provide in‑depth training and project‑specific guidance.
Assists in developing faculty and research staff education programs on specialized research administration topics and disseminates new knowledge through workshops and ad‑hoc groups.
Regulatory and Institutional Compliance
Completes the HRP‑903 Radiation Review Form and Ancillary Review for studies via CATS IRB, as applicable, collaborating with the Radiation Review Committee.
Completes the CTO Ancillary Review for studies via CATS IRB, as necessary.
Preferred Experience
ACRP or SoCRA certification
Clinical research study coordination experience
Clinical background (e.g., RN, LPN, EMT‑P, RT, pharmacist, etc.) strongly preferred
Professional Levels
Intermediate Professional – Performs Medicare Coverage Analysis on non‑oncology drug studies; may perform coverage analysis on device studies in close collaboration with a senior team member.
Advanced Professional – Provides Medicare Coverage Analysis on non‑oncology and cooperative group oncology studies independently; may perform coverage analysis on sponsored oncology studies with a senior team member.
Senior Professional – Provides Medicare Coverage Analysis on oncology and non‑oncology studies.
Principal Professional – Provides Medicare Coverage Analysis on oncology and non‑oncology studies.
Salary & Benefits Salary range: $51,000.00 – $115,100.00. Penn State provides a competitive benefits package, including comprehensive medical, dental, and vision coverage, robust retirement plans, generous paid time off, and a 75% tuition discount for employees and eligible family members.
Employment Requirements Successful background check in accordance with University policies is required. Applicants must be authorized to work in the U.S.; Penn State does not sponsor or take over sponsorship of a staff employment visa.
EEO Statement Penn State is an equal opportunity employer and is committed to providing employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. If you are unable to use our online application process due to an impairment or disability, please contact 814‑865‑1473.
#J-18808-Ljbffr