WVU Medicine

Office Support

• Process requests for patient transportation
• Ensure proper medical necessity when possible
• Coordinate pre-approvals when necessary
• Assist with Physician Certification Statement completion and compliance with requesting facilities
• Answer phone calls and provide exceptional customer service
• Monitor ground asset locations for accurate tracking and transport coordination
• Use the CAD system to enter call information and assign assets efficiently
• Work with mutual aid agencies to coordinate transport needs
• Ensure paperwork compliance and crew feedback processes
• Provide logistics support and restock assets
• Assist with data entry, filing, and keeping operations organized
• Provide administrative and operational support across patient care documentation, logistics, supply chain, facilities, and related areas
• Collaborate with the Monongalia EMS Duty supervisor

Office Support Dispatch Specialist

Scheduler

• Schedule, cancel, reschedule, and register outpatient visits and procedures for multiple ambulatory clinics
• Check in and check out patients according to scheduling and registration guidelines
• Obtain and verify patient guarantor information and generate referrals or authorizations when needed
• Schedule and register patients based on scheduling guidelines and medical appropriateness
• Coordinate follow-up appointments and testing at checkout
• Collect necessary patient information for scheduling and registration
• Identify and communicate scheduling modifications and development needs
• Notify appropriate personnel of scheduling changes caused by cancellations
• Respond to patient and staff needs and complaints, involving supervisors and patient representatives as needed
• Consult referring physicians’ offices to obtain and verify complete written or electronic orders
• Collect time-of-service payments, copayments, and managed-care waiver signatures
• Reconcile the cash drawer at the end of the day and report discrepancies
• Complete Workques and daily scheduling-area tasks
• Respond to patient communications in a timely manner

Therapist

• Evaluate and provide care for respiratory therapy patients
• Administer prescribed respiratory therapeutic services
• Perform basic and advanced therapeutic procedures for neonatal, pediatric, adult, and geriatric patients by physician order
• Assemble, check, correct malfunctions, and perform quality controls on Respiratory Care equipment
• Initiate, maintain, and discontinue mechanical ventilation for adult, pediatric, and neonatal patients
• Communicate with healthcare team members regarding patient care
• Assist with patient and family/caregiver education
• Participate in departmental quality assurance and hospital-wide performance improvement activities
• Perform basic and advanced diagnostic procedures by physician order
• Maintain clinical and professional competency according to established standards
• Perform all relevant departmental competencies

Respiratory Therapist

Consultant

• Develop and maintain collaborative relationships with physicians, hospitals, ancillary providers, and vendors
• Shape the provider network landscape through objective data and education across stakeholders, markets, and product lines
• Educate providers on credentialing, contracting, authorizations, referrals, claims, grievances and appeals, health education, population health, care management, pharmacy management, electronic health records, health information exchange, data exchange, and regulatory updates
• Conduct provider outreach through email, telephone, in-person meetings, and webinars
• Assess provider efficiencies when dealing with the health plan
• Conduct initial provider orientations and ongoing educational outreach
• Conduct group training sessions
• Assist with provider contract questions, research problems, and resolve escalated issues
• Represent the health plan at healthcare association functions
• Participate in regulatory reporting for provider networks
• Monitor competitors and market regulations
• Support strategic positioning to develop and maintain provider networks
• Assist the Credentialing Department with difficult-to-obtain documents
• Collaborate with Claims Operations, Medical Management, Credentialing, Contracting, Legal, Analytics, Compliance, Sales and Marketing, and Member and Provider Service teams
• Report to the Manager Network Services

Network Service Consultant

Strategist

• Design, innovate, and implement solutions to improve systems and processes
• Advocate for customers, understand business needs, and identify improvement and productivity opportunities
• Assess analytical needs and determine appropriate courses of action
• Manage relationships across project teams and facilitate optimal solutions
• Maintain a thorough understanding of database structures and business intelligence tools
• Serve as the first point of contact for data analytics and process improvement
• Perform data analysis and create queries, programs, and automation
• Validate that reported data is meaningful and accurate
• Lead data requirements gathering for problem identification, resolution, and solution design
• Provide analytical insights to drive strategic business decisions
• Coordinate cross-functional project teams and provide project/task coordination services
• Identify and document issues, barriers, and risks for management
• Manage workload, deadlines, expectations, scope changes, and deliverables
• Implement project changes according to change control policies and procedures
• Communicate project nature, significance, and risk factors to all parties
• Participate in post-implementation project reviews
• Gather customer requirements and translate business needs into actionable solutions
• Participate in training and professional development sessions
• Support co-workers and contribute to positive team spirit and cooperative problem-solving

Business Optimization Strategist

Project Manager

• Lead project teams on organization-wide mid-to-low risk IT projects affecting multiple people across a limited number of areas or departments
• Manage smaller-scale projects as needed
• Plan, direct, and coordinate all aspects of IT projects, including work plans, reporting, issue tracking, scope, costs, resources, timelines, communications, and risks
• Collaborate with IT, vendors, and customers to ensure successful project completion
• Serve as liaison between Information Technology and affiliated health-system practices
• Conduct on-site visits, facilitate communication, resolve client requests, and oversee issue resolution outside defined projects
• Review project proposals and determine goals, timelines, funding, approach, staffing, deliverables, and resource allocation
• Create and maintain project work plans, scopes/charters, schedules, information processes, issue/risk logs, and change-control documentation
• Communicate project status, issues, and successes to teams, management, and stakeholders
• Conduct routine project meetings and provide guidance, direction, motivation, and performance discussion
• Manage internal project resources and external consultants, contractors, and vendors
• Schedule project activities and team work; manage vendor relationships, escalations, and invoicing
• Manage project budgets typically under $500,000
• Identify and resolve project problems, evaluate alternatives, and facilitate solutions
• Establish relationships, resolve conflicts, influence stakeholders, and keep projects on course
• Use project-management software and tools including Windows, MS Project, MS Office, and MS SharePoint
• Participate in departmental planning, change implementation, staff meetings, and productivity improvement
• Mentor, train, coach, and support co-workers; create and update internal documentation
• Travel to other facilities or affiliated sites for implementations, training, and support as required
• Adhere to WVUHS and assigned-entity policies

IT PMO Project Manager

• Monitor OR scheduled cases to ensure availability and accurate scheduling
• Run equipment checks for all scheduled cases
• Coordinate scheduled cases to manage block utilization
• Communicate with staff, surgeons, outside schedulers, and outside entities necessary to the OR
• Monitor vendors, students, and representatives for required documentation before restricted-area entry
• Assist with urgent and emergent surgery/procedure scheduling
• Coordinate internal and external equipment needs and report equipment issues
• Maintain and optimize the OR schedule; address gaps, availability, add-on cases, and cancellations
• Collaborate with Service Line Coordinators and Charge staff on schedules and case placement
• Receive and document staffing phone calls
• Create and verify OR surgical procedures
• Monitor, audit, and document Temptrak
• Monitor completeness of documentation for medical concerns
• Initiate emergency staff call-in processes and log callback times
• Print peri-procedure documentation
• Transport equipment, human tissue, blood, or specimens as needed
• Generate daily schedules and reports and provide end-of-shift reports
• Enter and update Anesthesia Assignments
• Provide operating room scheduling support for various departments

Operating Room Scheduler

Supervisor

• Oversee centralized payer enrollment and reporting processes for facilities and providers
• Supervise enrollment and reporting staff, including hiring, training, performance reviews, workload assignment, and problem resolution
• Develop productivity standards, tracking reports, processes, and workflows
• Supervise completion, submission, tracking, and follow-up for facility and provider applications
• Advise the Director of Professional Services and notify administrators or VPs about enrollment issues and process breakdowns
• Research enrollment requirements and ensure documentation complies with policies, regulations, and accreditation standards
• Maintain credential database integrity and coordinate with IT and the software vendor to resolve issues
• Oversee preparation of HPN rosters, ASO reports, provider profiles/rosters, and staff meeting reports
• Supervise monthly system-wide enrolled-provider reporting for compliance and revenue-cycle operations
• Ensure payer reporting compliance for more than 20 delegated-credentialing payers
• Develop and maintain service benchmarks and quality-improvement programs
• Communicate with payers to resolve authorization and billing denials related to participation status
• Collaborate with medical staff leaders, hospital administrators, office managers, billing managers, departments, personnel, and customers
• Maintain confidentiality, professionalism, attendance, punctuality, and a collaborative work environment

Supervisor, Payer Enrollment & Reporting

Analyst

• Review, execute, and oversee processing of member enrollment application information for Peak Health’s Plan Suite
• Manage weekly enrollment files and daily ACA/Marketplace enrollment transactions
• Reconcile membership, coverage, Marketplace, issuer, and CMS records
• Maintain member enrollment records, including APTC and CSR information
• Process new enrollments, maintenance transactions, cancellations, terminations, reinstatements, plan changes, SEP requests, SNP applications, and 834 transaction files
• Resolve enrollment discrepancies, transaction errors, rejects, exceptions, and eligibility issues
• Complete EDV monthly processes, REED submissions, LEP data files, MPWR files, and CMS reconciliation processes
• Monitor enrollment work queues and meet production, quality, CMS, and organizational timeliness standards
• Respond to member inquiries regarding enrollment procedures, benefits, and eligibility requirements
• Develop and deliver department training to new hires and maintain job aids and standard operating procedures
• Participate in system testing, UAT, validation activities, Open Enrollment planning, and process improvement initiatives
• Analyze enrollment data, identify trends and discrepancies, and prepare management reports
• Ensure compliance with CMS Marketplace regulations, federal and state regulations, issuer guidelines, and internal policies
• Collaborate with underwriting, billing, customer service, Marketplace representatives, vendors, and other stakeholders
• Maintain enrollment databases and software and troubleshoot system-related issues

Enrollment Analyst – ACA Enrollment

Nurse

• Triage incoming patient referrals, assess patient needs, provide clinical dispositions, and facilitate referrals to primary and specialty care providers
• Educate patients about immediate care advice and preventive behaviors
• Accompany patients to appointments and coordinate travel, accommodations, and itineraries
• Assess and coordinate multidisciplinary care across the care continuum
• Collaborate with care teams to expedite patient workups, treatment, survivorship, and end-of-life care
• Schedule and coordinate clinic, e-visit, and telehealth appointments
• Communicate clinical information between patients and providers
• Assess health literacy and educational needs and provide clinical education
• Document patient needs, goals, preferences, conversations, and care plans in the medical record
• Identify care gaps, troubleshoot transitions and barriers to care, and communicate with referring and primary care providers
• Provide direction and guidance to Patient Navigators
• Participate in service line team meetings

Nurse Navigator – Population Health

General

• Provide Advanced Life Support (ALS) patient care
• Perform comprehensive patient assessments
• Initiate and maintain appropriate medical treatments
• Complete accurate and timely electronic patient care reports (ePCRs)
• Ensure assigned ambulance and equipment are operational

Paramedic – Part-Time

• Provide Basic Life Support and limited Advanced Life Support patient care consistent with protocols
• Conduct patient assessments and formulate treatment plans
• Administer medications and monitor patients during transport
• Maintain documentation of patient care and adhere to HIPAA regulations
• Participate in training and quality improvement activities as required

AEMT – Part-Time

• Functions as an Advanced Life Support (ALS) clinician responsible for the assessment, treatment, stabilization, and transport of patients in the prehospital and interfacility transport environments.
• Provide emergency medical care consistent with West Virginia Office of Emergency Medical Services (WVOEMS) Scope of Practice and West Virginia Statewide EMS Protocols.
• Responsible for patient care, documentation, operational readiness of equipment and vehicles, professional conduct, and participation in training and quality improvement activities.
• Represent Monongalia EMS through professional interactions with patients, families, healthcare providers, public safety partners, and the community.

Paramedic – Full-Time

• Provide emergency medical care and patient assessment
• Perform advanced airway management
• Maintain operational readiness of equipment and vehicles
• Document patient care in electronic records
• Collaborate with healthcare providers and public safety partners

AEMT – Full-Time

• Examine and analyze medical records associated with asserted and potential malpractice claims
• Assist litigation counsel with preparation and presentation of defenses in asserted medical negligence claims
• Assist in assessing risk management and internal control weaknesses
• Prepare and track documents to be sent to and received from external experts and internal departments
• Review medical record documentation for accuracy, completeness, and standards of care
• Organize and index internal medical records
• Perform medical literature research to assist in identifying standard of care and subject matter experts
• Collect documents and other information necessary to respond to discovery requests
• Research policies, including legacy policies, federal and state regulations
• Interview hospital employees and other potential witnesses
• Supplement and maintain up-to-date information in legal services department’s expert witness database
• Interact with and assist outside counsel with coordination of witness interviews and depositions
• Assist in preparation of exhibits for use at mediation, hearings and trial
• Attend depositions, hearings, and trials as requested by litigation counsel
• Serve as liaison between clinical staff and outside counsel