Clinical Finance Case Management Consultant - RN

About the role

The Clinical Research Finance & Compliance (CRFC) Department supports the financial infrastructure of oncology clinical trials, handling project budgeting, contract negotiation, revenue forecasting, and post-award accounting. Key department functions include project costing and financial forecasting, contract and budget negotiation, revenue recognition and monthly reconciliation, invoicing, accounts receivable, and audit compliance, coverage analysis, patient claim review, and reimbursement processing. CRFC partners with the Clinical Trials Office (CTO), Principal Investigators (PIs), and research and business units across the Medical Center and College of Medicine.

Reporting to the Director of Clinical Research Finance & Compliance, the Clinical Financial Case Management Consultant – RN serves as a key technical expert and knowledge leader responsible for ensuring compliance with clinical trial billing regulations, including Medicare guidelines. This role supports accurate billing for OSUCCC–James patients participating in clinical trials. The consultant manages a portfolio of clinical trials, conducting comprehensive reviews of study protocols to classify procedures as either Routine Care or Research-related (Coverage Analyses) to guide appropriate billing and coding practices. The role also performs ongoing reviews in response to protocol amendments or changes in applicable laws and regulations, provides guidance to Revenue Cycle Specialists and Analysts, serves as a clinical subject matter expert within the CRFC team, and collaborates with key stakeholders including PIs, CTO, James Nursing, Revenue Cycle, and the Research Billing Office. This position requires independent work and high-level decision-making informed by a deep understanding of scientific protocols, federal regulations, and clinical operations.

Responsibilities

• Manage a portfolio of clinical trials and conduct comprehensive Coverage Analyses to classify procedures as Routine Care or Research-related
• Guide appropriate billing and coding practices based on Coverage Analyses
• Perform ongoing reviews in response to protocol amendments or changes in laws and regulations
• Provide guidance to Revenue Cycle Specialists and Analysts
• Serve as a clinical subject matter expert within the CRFC team
• Collaborate with Principal Investigators, Clinical Trials Office, James Nursing, Revenue Cycle, and Research Billing Office
• Ensure compliance with clinical trial billing regulations, including Medicare guidelines
• Support accurate billing for OSUCCC–James patients participating in clinical trials

Requirements

• Bachelor's degree or equivalent experience
• Registered Nurse (RN) licensure
• 6 years of relevant experience required
• Must maintain RN licensure ongoing

Qualifications

• 8-12 years of relevant experience preferred
• Master’s degree preferred
• Experience with clinical trials preferred
• Familiarity with Medicare billing regulations and hospital patient billing a plus