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#89013 Sr. Clinical Trial Coverage Analyst

Initial Review Date: Fri 9/22/2017

Revisions have been made to this job description to reflect the business needs effective 08/01/17.

UCSD Layoff from Career Appointment: Apply by 7/25/17 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.

UC San Diego career employees who have passed their trial period will have priority consideration for this position. Recruiters will begin to refer qualified internal applicants after the first 7 days of the job posting. Qualified external applicants may be referred to the hiring department, if a qualified pool of internal candidates is not identified and upon the request of the hiring manager.


RNs, LVNs and other clinical professionals are encouraged to apply!

The Sr. Clinical Trial Coverage Analyst will have familiarity with a clinical trial protocol and related regulatory documents in order to prepare clear documentation of who the payor will be for all medical procedures and services required in a clinical research project. The Coverage Analyst determines whether proposed clinical projects are a qualifying clinical trial as defined by CMS’ Medicare Clinical Trial Policy and determines what is billable after reviewing the Medicare Benefits Policy manual, relevant National Coverage Decisions (NCDs) and Local Coverage Decisions (LCDs), Code of Federal Regulations (CFRs), state laws, and when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region.

The Coverage Analyst will perform coverage analyses that include the development of the coverage analysis (CA) grid and billing justifications of varying complexity with information in compliance with UCSD policies. The Coverage Analyst must be extremely comfortable working with numerous databases and electronic information, able to quickly read and comprehend large amounts of scientific, medical, and legal text. The analyst will have initiative, use good judgement and tact, interact with various internal and external customers with ease, and be highly resourceful and motivated in resolving clinical project issues in order to fulfill campus objectives. Candidates should have clinical or research experience, a strong understanding of protocol design and conduct, and a general understanding of applicable federal, state and local clinical research billing laws, regulations and policy.

The Coverage Analyst is an experienced professional who knows how to apply theory and put it into practice with in-depth understanding of the professional field; independently performs the full range of responsibilities within the function; possesses broad job knowledge; analyzes problems / issues of diverse scope and determines solutions.

The analyst must use skills as a seasoned, experienced research compliance professional with a full understanding of industry practices and organization policies / procedures to apply federal, state, and university regulations, policies, and guidelines, and promotes best practices. The analyst will interact frequently with investigators, persons in other organization departments and occasionally persons outside the University that will require the use of tact and independent judgment, knowledge of standards and best practices, and counseling to resolve a wide range of research compliance issues. The analyst is required to demonstrate good judgment in selecting methods and techniques for obtaining solutions. Errors or omissions may ultimately place research participant at undo risk and / or compromise the institution's assurance of regulatory compliance with the federal government.


  • Bachelor’s Degree in clinical or science subject or related area and / or equivalent experience / training or at least 2 years of experience in clinical care, research or related field.

  • General knowledge of clinical care or clinical research and budget negotiations.

  • Ability to rapidly research online resources for information supporting billing rules and regulations. Ability to quickly read and comprehend large amounts of electronic text comprised of scientific, medical and legal language. Strong problem-solving and decision making skills.

  • Excellent interpersonal skills including tact, diplomacy, flexibility and professionalism in dealing with faculty, staff and industry representatives. Excellent communication skills both verbal and written.

  • Knowledge of medical terminology.

  • Advanced skills in using software applications such as Microsoft Excel, Microsoft Word, Microsoft PowerPoint, database applications, and internet search engines. Ability to learn new systems with ease.

  • Ability to effectively collaborate with multiple departments and demonstrate ability to work in a team environment, particularly using electronic resources and communication.

  • Ability to work independently and quickly with self-motivation and good judgment. Ability to handle multiple projects and tasks simultaneously.


  • Proven skills in completing complex projects using independent judgment and ability to troubleshoot problems quickly and effectively in order to maintain solid operational responsibilities.

  • Knowledge of regulatory, financial and administrative requirements of third party billing for clinical care or research.

  • Knowledge of research regulatory requirements (including FDA and other federal and state regulations), GCP/ICH guidelines, and special requirements for drug and medical device trials.

  • Working knowledge of IRB policies and procedures, SB 37 and NCD 310.1 and other regulations relevant to clinical research.

  • 2 years recent experience as a clinical research professional.

  • Familiarity with industry contracting or the ability to learn and grasp basic clinical trials contracting concepts.

  • CCRP, ACRP or similar research related certification preferred.

  • Demonstrates expertise in protocol assessment, IRB submission, and clinical trials budgeting/negotiation.

  • Experience working with faculty, administrators, and staff in an academic medical center, health care or university environment.


  • Must be willing to work various hours and travel to sites as necessary.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, and several outpatient clinics. UC San Diego Medical Center in Hillcrest is a designated Level I Trauma Center and has the only Burn Center in the county. We invite you to join our dynamic team!


Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.


UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UCSD School of Medicine
Payroll Title:
Hiring Salary Range
$4,875.00 - $7,500 / Month
East Campus
Appointment Type:
Appointment Percent:
Total Openings:
Work Schedule:
Days, 8 hrs/day, Mon-Fri