Clinical Finance Case Management Consultant - RN

The Ohio State University Wexner Medical Center; Columbus (OH); On-site; USD 90,000 - 120,000; Full time

Job summary

The Ohio State University Wexner Medical Center is seeking a Clinical Financial Case Management Consultant - RN to ensure compliant billing for oncology clinical trials. You will review study protocols to categorize procedures as Routine Care or Research, perform Coverage Analyses, and advise Revenue Cycle staff.

The role requires RN licensure and 6 years of relevant experience, with 8–12 years preferred; familiarity with Medicare billing is a plus.

Qualifications

• Bachelor's degree or equivalent experience.
• Registered Nurse licensure required.
• 6 years of relevant experience required; 8–12 years preferred.
• Experience with clinical trials is preferred.
• Familiarity with Medicare billing regulations and hospital patient billing is a plus.

Responsibilities

• Ensure compliance with clinical trial billing regulations, including Medicare guidelines.
• Manage a portfolio of clinical trials, performing Coverage Analyses to classify procedures as Routine Care or Research.
• Provide guidance to Revenue Cycle Specialists and Analysts and collaborate with PIs, CTO, and other stakeholders.
• Maintain independence in decision-making with knowledge of scientific protocols and regulatory requirements.

Skills

RN licensure

Clinical trials experience

Medicare billing knowledge

Financial analysis

Education

Bachelor's degree

Master's degree (preferred)

Job description

Scope of Position

The Clinical Research Finance & Compliance (CRFC) Department plays a vital role in supporting the financial infrastructure of oncology clinical trials. CRFC is responsible for the full spectrum of financial operations, including project budgeting, contract negotiation, revenue forecasting, and post-award accounting.

Key functions of the department 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 closely with the Clinical Trials Office (CTO), Principal Investigators (PIs), and research and business units across the Medical Center and College of Medicine. The team ensures accurate and timely financial communication and transactions with both internal stakeholders and external sponsors.

Position Summary

Reporting to the Director of Clinical Research Finance & Compliance (CRFC), 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 Clinical Financial Case Management Consultant - RN will manage a portfolio of clinical trials, conducting comprehensive reviews of study protocols to classify procedures as either Routine Care or Research-related. These reviews—known as Coverage Analyses—guide appropriate billing and coding practices. The Clinical Financial Case Management Consultant - RN will also perform ongoing reviews in response to protocol amendments or changes in applicable laws and regulations.

In addition to conducting Coverage Analyses, the Clinical Financial Case Management Consultant - RN will provide guidance to Revenue Cycle Specialists and Analysts, serve as a clinical subject matter expert within the CRFC team, and collaborate with key stakeholders including Principal Investigators (PIs), the Clinical Trials Office (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.

Minimum Qualifications

For Hire: Bachelor's degree or equivalent experience. Registered Nurse. 6 years of relevant experience required. 8-12 years of relevant experience preferred. Master's degree preferred. Experience with clinical trials is preferred. Familiarity with Medicare billing regulations and hospital patient billing is a plus.

Ongoing: Must maintain RN licensure.

The university is an equal opportunity employer, including veterans and disability.

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.