WVU Medicine

Director

• Ensure licensure is completed within 100 days of hire
• Engage in responsibilities that necessitate a pharmacist's license once full licensure is obtained
• Oversee pharmacy administration duties in a health-system environment
• Collaborate with healthcare professionals to ensure quality pharmacy services
• Manage compliance with accreditation standards

Director of Pharmacy

Analyst

• Responsible for the technical EPIC HB contract build and modeling functions including the Hyperdrive, Text, and Data Courier environments.
• Responsible for design, development and testing of reports using innovative techniques, analyzing data from various sources and systems.
• Prepare accurate data analysis in order to communicate with regulatory agencies, contracted payers and internal leadership.
• Build and maintain advanced Microsoft Excel contract models in order to meet the functional needs of staff and streamline process flow.
• Recommend and implement technical solutions to assist in planning, streamlining and decision making.
• Maximize reimbursement by analyzing contract variances, new technology, denial trending, payment variance trending and regulatory changes.
• Use of performance improvement, project management and technology skills.

Systems and Contracts Analyst

Medical Billing and Coding

• Serves as lead responsible for monitoring, maintaining and coordinating work assignments.
• Performs ongoing audits of select inpatients and outpatient accounts.
• Provides training to ensure optimum reimbursement and hospital coding compliance.
• Ensures accurate and appropriate information is documented, coded, and entered into the system(s).
• Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment.

Lead Coding Specialist

Accountant

• Performs a wide range of professional accounting functions in accordance with Generally Accepted Accounting Principles (GAAP) and Statutory Accounting Principles (SAP) to support the month-end financial statement process of Peak Health entities.
• Completes documentation and schedules during month-end, budget preparation, and external audit.
• Prepare quarterly and annual statutory reporting, filings, and compliance tasks.
• Provides financial guidance to department managers to help control costs and provide organization-wide efficiencies.
• Aid in the planning and build out of statutory quarterly and annual financial statements.
• This may include the coordination and preparation of all footnote disclosures, management discussion and analysis, and internal controls.
• Tracking, managing, and submitting all U.S. (State based and NAIC) Finance related regulatory fees and filings.
• Making, recording, and reconciling government business capitated payments.
• Prepare and file State-Specific Finance Forms and supplements including various schedules.
• Monitor due dates and ensure timely compliance with state filing deadlines pertaining to Finance filings.
• Track and submit renewals, fees, and changes in company information to each state regulator.
• Coordinate with regulatory reporting function to ensure Finance accountabilities align with overall regulatory filing calendar.
• Corresponding with regulators proactively as needed.
• Partner with applicable parties to ensure proper support of general ledger data/applications supporting external statutory accounting and financial reporting.
• Reconcile and explain GAAP vs STAT differences, particularly in areas like loss reserves and premium recognition.
• Manage risk-based capital (RBC) calculations, asset admissibility, and premium deficiency testing.
• Oversee reinsurance accounting, including ceded/assumed premiums and recoverables.
• Support loss reserve development, including IBNR estimation and actuarial collaboration.
• Respond to state regulatory inquiries to support routine financial inquiries.
• Analyze underwriting results and trends impacting statutory profitability.
• Reconcile cash accounts associated with claim disbursements associated with government products.
• Accountable for ensuring governmental products premium billing process is accurate.
• Reconciling Medicare Advantage Prescription Drug payable and receivables, including cost sharing programs and rebates.
• Assist in accounting and treasury management of the investment portfolio.
• Coordinate with the tax department in accounting for and transacting various regulatory taxes.
• Supporting the accounting classification of expenses between Medical and Administrative.
• Supporting the development of regulatory rate setting, by assisting in the provision of administrative expense actual and projections.
• Support the filing of various regulatory financial schedules and attestations, including but not limited to MLR filings, Medicare DIR filings, etc.
• Coordinate with the Actuarial and Operational Analytic functions to maintain risk adjustment accruals.
• Develop strong relationships with Department managers to help coordinate and monitor financial controls over the organization’s cost centers according to approved budget guidelines.
• Coordinate accounting and financial processes to maximize efficiency in the daily accounting operations. Ensure that internal control measures are being followed.
• Maintain general ledgers to complete and submit accurate financial data during month-end process according to predetermined deadlines.
• Lead and coordinate month end variance analysis.
• Oversee and review month end general ledger reconciliations.
• Directly supervise the work and development of assigned Accounting Department staff.
• Coordinate other staff duties to accomplish department goals and objectives. Delegate projects/duties, as necessary.
• Develop and submit analytical financial data as needed by department director/manager.
• Assist in completing and compiling financial support documentation for budget and external audit purposes.
• Assist in coordination of the budget and external audit review.
• Train new personnel and monitor their progress.
• Participate in educational opportunities as provided by Peak Health to enhance skill related abilities.
• Complete other duties as assigned by manager.
• Support performance improvement and quality assurance initiatives.

Senior Accountant – Statutory

• Develop strong relationship with Department managers to help coordinate and monitor financial controls over the organization’s cost centers according to approved budget guidelines.
• Coordinate accounting and financial processes to maximize efficiency in the daily accounting operations.
• Maintain general ledger in order to complete and submit accurate financial data during month-end process according to predetermined deadlines.
• Lead and coordinate month end variance analysis.
• Oversee and review month end general ledger reconciliations.
• Oversee the work and development of assigned Accounting Department staff.
• Coordinate other staff duties to accomplish department goals and objectives. Delegate projects/duties as necessary.
• Develop and submit analytical financial data as needed by department director/manager.
• Assist in completing and compiling financial support documentation for budget and external audit purposes.
• Assist in coordination of the budget and external audit review.
• Train new personnel and monitor their progress.
• Participate in educational opportunities as provided by the hospital to enhance skill related abilities.
• Support performance improvement and quality assurance initiatives.
• Ensure duties of specialty focus are completed accurately and timely (i.e., monthly financial statements, consolidated financial statements, bonds, cash flow projections, etc.)

Senior Accountant – SMG

Manager

• Oversees the denial and appeal processes for the health system
• Provides leadership to the clinical denial coordinators and assigned staff
• Prioritizes, analyzes, and develops process improvement initiatives to reduce risk of revenue loss
• Works in collaboration with the Clinical Financial Integration team to ensure appropriate revenue capture for the system

Manager, Clinical Denials

• Ensure accurate and appropriate coding classification to meet departmental, hospital and agency requirements.
• Obtain accurate documentation in the medical record for coding assignment.
• Code moderately complex patient classes (i.e. ED, observations, same day care).
• Review and accurately interpret medical record documentation to assign ICD-10, CPT, or modifier codes.
• Assure quality and timely coding, charging, and abstraction is completed for assigned areas.
• Maintain current coding knowledge through various educational methods.
• Contact physicians to obtain necessary information for coding assignments.

Coding Specialist II, Day Surgery

• Codes inpatient and/or IRAD 90% of current FTE status.
• Reviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD).
• Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation.
• Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.).
• Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas.
• Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.
• Assures the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required for to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.

Inpatient Hospital Coding Specialist III

• Support the operational efficiency of the Pharmacy Department by coordinating fiscal management activities.
• Perform data analysis and maintain departmental statistics and reports.
• Coordinate accounting and financial processes to maximize efficiency in daily operations.
• Review medication purchases, revenue, and contract pharmacy fees.
• Generate reports related to current expenses as the basis for the budget.
• Assist in completing financial documentation for budget and audits.

Pharmacy Analyst – 340B

Administration

• Manage all scheduling and timekeeping functions for WVU Medicine’s Staffing Solutions Program
• Receive and respond to communication outside of normal business hours
• Manage multiple commitments to hit payroll deadlines
• Handle timekeeping functions including obtaining, entering, and posting schedules
• Ensure all incentives are tracked, entered, and updated according to each facility’s offerings
• Maintain open lines of communication with staff to manage schedules and answer inquiries
• Collaborate with cross-functional teams and share documents efficiently

Scheduling & Timecard Administrator – Specialist

Operations

• Assists in most aspects of drug distribution under the supervision of a pharmacist
• Responsible for preparing unit-dose medications and delivering medications
• Reads physician orders/prescriptions and prepares medication for dispensing
• Communicates with patients or care givers regarding medication delivery and pick-up
• Maintains inventory and supplies in assigned pharmacy service areas
• Ensures that pharmacy service areas are clean and orderly

Community Pharmacy Operations Technician, Part-Time

• Assists in drug distribution under pharmacist supervision
• Prepares unit-dose medications and medication for dispensing
• Communicates with patients regarding medication and schedules
• Takes inventory and maintains supplies in pharmacy service areas

Community Pharmacy Operations Technician – Full-Time

Auditor

• Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers.
• Will oversee or perform the overall auditing and education plans for the Coding staff.
• Perform coding quality audits, provide ongoing feedback and education.
• Utilize various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment.

Hospital Coding Auditor – Educator

Therapist

• Evaluates and treats patients who have difficulty performing daily tasks due to physical, emotional, cognitive, and/or psychosocial conditions.
• Provides coordinated and comprehensive patient care including assessment, expected outcomes, rehabilitation interventions and evaluation within an interdisciplinary team approach.
• Evaluates patient needs and develops and implements the treatment programs for assigned patients to identify, prevent, and to minimize physical disabilities and/or pain of patient.
• Documents all treatments, according to department policies and procedures, as monitored by supervision, by documentation review and consultation with referring Provider.
• Submits accurate charges for services rendered for patients, according to departmental policies and procedures utilizing the billing system via the patient’s EMR.
• Carries out oversight responsibilities to ensure supervision of COTAs, students and volunteers.
• Participates in education and training of staff, students, patients, and family members to assure the appropriate delivery of care and to achieve the mission of WVU Medicine.

Acute Care Occupational Therapist, OT

• Provide direct ABA therapy to children with Autism and other developmental disorders in the clinic, home, school, and community settings.
• Provide parent, teacher, and staff training on the principles of ABA and behavior modification.
• Provide training and supervision to Behavioral Technicians.
• Conduct functional behavioral assessments/analyses.
• Conduct verbal behavior/language assessments (VB-MAPP/ABLLS-R).
• Develop individualized treatment plans (e.g., goals, objectives, and interventions) and monitor client progress towards goals.
• Consult and collaborate with schools, daycares, medical professionals, and other pediatric disciplines.
• Assist with administrative tasks and oversight of the ABA department (including ensuring compliance with insurance requirements for session notes, treatment plans, supervision, treatment authorizations, RBT requirements, etc.).
• Participate in Continuous quality improvement efforts
• Consult on and supervise internal and external research projects as directed by BCBA Supervisor