Job Information
Houston Methodist Director, Clinical Research Finance & Billing in Houston, Texas
At Houston Methodist, the Director Clinical Research Finance position is responsible for compliant clinical research billing program. This position develops and implements institutional policies. It directs the creation of appropriate processes and controls to ensure the appropriate processing of clinical research billing to insurance payors and sponsors which support the clinical research program. The Director Clinical Research Finance position is responsible for the oversight of a centralized clinical research billing unit that utilizes the Electronic Health Record system in collaboration with both Houston Methodist Specialty Physician Group (HMSPG) and Corporate Revenue Cycle, Medical Records, Corporate EPIC team, Clinical Operations, Office of Grants Administration, Office of Research Contracts, Houston Methodist Research Institute (HMRI) Financial Reporting and Accounting, Principal Investigators (PIs), and study team members to ensure clinical research billing compliance with The Houston Methodist's guidelines, as well as federal and state regulations. The Director Clinical Research Finance position develops and implements processes for changes in The Center for Medicare and Medicaid Services (CMS) billing guidelines and other regulations that impact Houston Methodist Research Institute (HMRI)'s clinical research billing program. This position directs the creation of appropriate processes and controls to ensure financial close outs of clinical research studies are timely and accurate.
The Director position responsibilities include overseeing the activities of the department staff, ensuring quality, productivity, functional excellence and efficiency to accomplish strategic and operational objectives. In addition, this position is accountable for employee engagement, adequate staffing levels, budget development and compliance, staffing decisions such as hiring and terminating employment, coaching and counseling employees on work related performance, and developing and implementing policies and procedures to ensure a safe and effective work environment. This position also ensures training, monitoring and operations initiatives are implemented which secure compliance with ethical and legal business practices and accreditation/regulatory/government regulations.
PEOPLE ESSENTIAL FUNCTIONS
Directs, develops, and implements strategic and operational/high level projects and processes either through independent/highly autonomous work or through the facilitation of work teams to enable the effective and efficient completion of objectives.
Oversees management of and ensures development for staff to meet overall objectives in terms of quality, service, and cost effectiveness. Provides timely guidance and feedback to help others strengthen specific knowledge/skill areas needed to accomplish a task or solve a problem. Directs management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees.
Meets or exceeds threshold goal for department turnover and/or system metrics on employee engagement indicators.
Provides leadership and communication to maintain a competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, completing performance appraisals, conducting new hire feedback sessions, coaching/corrective counseling, and providing recognition/commendations to achieve desired outcomes.
Identifies opportunities and takes action to build strategic relationships between one's area and other areas, teams, departments, and units to achieve business goals. Drives the promotion of teamwork within and between departments; participates and/or leads and facilitates department process improvements as needed.
Collaborates with Houston Methodist (HM) leaders to standardize the clinical research billing enterprise across HM organizations.
Coordinates with the IT teams to ensure the implementation and optimization of processes that support the clinical research billing functionality in the Epic and OnCore environments which includes oversight of a team of individuals to ensure processes are in place to support the technology and the development of a quality assurance team to ensure the synchronization of Epic and OnCore.
Serves as HMRI's representative for various ad hoc committees to develop standardized data elements, training and processes associated with clinical trials.
SERVICE ESSENTIAL FUNCTIONS
Oversees department operations, designated projects, schedules, and activities as needed to ensure that goals or objectives are accomplished within the prescribed time frame. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction.
Drives department service standards and activities to impact department and/or system score for patient/customer-based satisfaction, through role modeling and fostering accountability. Serves and actively participates on various entity committees as a voice for the department.
Coordinates with Institutional Compliance on the annual clinical research billing compliance objectives. Oversees vendor Consulting Group as it relates to an agreement between them and HMRI for work performed on Coverage Analysis for each clinical study.
Provides oversight, leadership and support for the development of the clinical research billing enterprise which includes the accuracy of the study calendar and coverage analysis for each clinical research study submitted for review by the Institutional Review Board (IRB), negotiation of the contract budget with the departments, quality assurance process between clinical trials management system and electronic health record, review of charges related to clinical research activities and monitoring of the actively enrolling clinical trials.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
Ensures a safe and effective working environment; monitors and/or revises the department safety plan and/or any specific accreditation/regulatory required safety guidelines. Responsible for staff maintenance of credentials and competencies, per accrediting/ licensing agency and/or department guidelines as applicable.
Employs a proactive approach in the optimization of safe outcomes and information systems by monitoring and improving the department workflow and enhancing operations, using peer-to-peer accountability and identifying solutions via collaboration. Implements process improvements utilizing tools such as lean principles. Role models situational awareness, using teachable moments to improve safety.
Responsible for employee compliance to policies and procedures and performs associated actions upon non-compliance (i.e., licensure/certification compliance, focal point review requirements, disaster plan, in-services, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.).
Provides compliance reports to executive leaders, as needed. Reports deviations and corrective action plans to executive leadership, as appropriate.
FINANCE ESSENTIAL FUNCTIONS
Develops and manages department operational and capital budgets, approvals, and ongoing maintenance of the department(s), ensuring operation in a cost-effective manner. Proactively identifies and plans for capital needs related to current equipment and future department projects. Ensures staffing plans and schedules meet department needs that reflect understanding of the importance of cost-effectiveness.
Creates department strategies to achieve financial target and staffing needs, through optimizing productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications.
Develops and negotiates clinical trial budgets on behalf and/or in collaboration with Principal Investigators and study teams. Builds relationships with sponsors and Contract /Clinical Research Organization's (CROs) to improve the timeliness of study activations. Coordinates budget development and negotiation training sessions, as needed.
Coordinates with various areas across HMRI to ensure the establishment of a standard close out process for clinical research studies which includes the timely and accurate review of budget categories to determine allowable and non-allowable expenses based on funding source guidelines.
Provides oversight of post-award activities related to clinical research studies to include sponsor billing, study account reconciliation, and assistance with study close out in MARS, OnCore, and EPIC.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
Identifies and implements innovative solutions for practice or workflow changes to improve department, entity, or system operations by leading unit projects and/or other department/ system-directed activities. Proactively leads task forces and committees. May represent HM at assigned community or professional organization meetings.
Drives change initiatives, maintaining effectiveness when experiencing major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements, or cultures. Partners effectively with stakeholders as appropriate.
Ensures own career discussions occur with appropriate management. Completes and updates My Development Plan (MDP) on an on-going basis. Conducts conversations with staff on their development and MDP.
Coordinates with Information Technology (IT), Central Offices and others to implement and optimize technology solutions that support clinical research activities which includes the implementation and optimization of the financial modules in OnCore, continuous process improvement initiatives and the optimization of processes to support daily operations, as needed.
This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
EDUCATION
Bachelor's degree in business, finance, healthcare administration, or related field
Master's degree preferred
WORK EXPERIENCE
Seven years business/people management experience with five years in a health care environment to include comprehension of clinical operations
Experience with OnCore and EPIC
LICENSES AND CERTIFICATIONS - REQUIRED
- N/A
KNOWLEDGE, SKILLS, AND ABILITIES
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially about activities impacting patient or employee safety or security
Demonstrates the ability to interact with others in a way that gives them confidence in one's intentions and those of the organization
Ability to use appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifying one's own behavior to accommodate tasks, situations and individuals involved
Demonstrates leadership qualities and critical thinking through self-direction initiative and effective interpersonal skills and oral/written communication skills
Ability to identify and understand issues, problems and opportunities, comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints and probable consequences
Extensive knowledge of regulatory and accreditation agency requirements that impact department; stays abreast of industry changes
Demonstrates highly effective communication skills-strong written communications and platform presentation abilities
Ability to work effectively in a fast-paced environment
Demonstrates flexibility and adaptability in the workplace
Capable of leading teams/facilitating groups, building consensus and garnering highest confidence in professionalism and work product by senior leadership
Ability to work under pressure and balance many competing priorities; highly responsive and solution/action oriented
Proficiency in spreadsheet, word processing, and presentation software
Maintains a positive and supportive attitude and demeanor
Professional handling of exposure to confidential/sensitive information
Ability to work efficiently under stress with time limits imposed
Interacts effectively with a variety of professionals, administrators, and support staff
Strong analytical and interpersonal skills.
Applies sound judgment in applying and interpreting policies, procedures, laws, rules, and regulations applying to compliance and monitoring.
In-depth knowledge of Medicare guidelines and other federal/state guidelines that govern clinical research billing
Knowledge of revenue cycle and the associated billing practices
SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE
Uniform No
Scrubs No
Business professional Yes
Other (department approved) No
ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.
- On Call* No
TRAVEL
Travel specifications may vary by department
May require travel within the Houston Metropolitan area Yes
May require travel outside Houston Metropolitan area Yes
Company Profile:
Houston Methodist Academic Institute oversees the Education Institute and Research Institute, including 772 faculty and 56,250 learners. The Academic Institute aligns our research and education initiatives in service to the clinical mission, providing solutions that answer the call for new technologies and skills our clinicians need for patient care.
Houston Methodist Education Institute coordinates our primary academic affiliation with Weill Cornell Medicine and other joint programs, including the Engineering Medicine Program at Texas A&M University Intercollegiate School of Engineering Medicine. The Education Institute also oversees continuing medical education and graduate medical education, and supports more than 1,000 trainees in residence for medical, nursing, allied health and research education programs.
Houston Methodist Research Institute supports research programs and infrastructure that enable faculty across the system to bring new scientific discoveries to patients as rapidly as possible through the full cycle of a cure from conceptual bench research, to prototyping and development, to clinical trials and FDA approval. The Research Institute supports more than 1,387 clinical research protocols and $70.3 million in extramurally funded translational research programs.
Houston Methodist is an equal opportunity employer inclusive of women, minorities, disabled persons and veterans.
Equal Employment Opportunity
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.
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