WVU Medicine

Manager

• Managing the inpatient dietitian staff and the outpatient dietitians
• Ensuring proper nutritional care and education of patients and/or families
• Developing and implementing department policies and procedures
• Maintaining effective documented communication with medical, nursing and administrative personnel
• Evaluating staff productivity and the need to increase staff
• Hiring, evaluating, directing, coordinating and supervising activities of clinical dietitians
• Ensuring implementation of clinical activities such as nutrition assessments, screening, nutrition care plans and patient education
• Coordinating quality improvement activities in performance of patient care
• Approving the diet manual and all menus and menu changes
• Providing orientation, in-service and continuing education for self, staff dietitians and food services technicians
• Participating in committee activities concerned with nutritional care

Manager, Clinical Nutrition

• Participate in activities related to care management program build, implementation, oversight, and delegation
• Assist in ensuring compliance with CMS SNP Model of Care (MOC) expectations, NCQA standards, and Medicare Advantage regulatory requirements
• Assists in the development and implementation of policies and procedures related to the Care Management process
• Assists with monitoring performance standards, productivity and ensuring staff coverage to meet the needs of the department
• Formulates, implements and evaluates educational strategies for staff
• Maintains a working knowledge of the requirements of regulatory and compliance entities
• Mentors new Care Managers and assists with training
• Provides support and coaching to Care Managers and other clinical team members
• Perform data collection and analysis of trends to determine areas of opportunity and strategies for better practices for the Care Management team
• Takes escalated calls or fills-in for the Care Manager team during high-peak periods
• Assist in quarterly reporting of delegated case management processes to meet accreditation standards
• Assist in submission of required documents/policies during application process to accrediting body
• Provides clinical, procedural or interpretational assistance
• Ability to present complex ideas and data to a wide variety of stakeholders from frontline employees to executive c-suite
• Establishes and maintains cooperative and positive working relationships with key stakeholders across the organization
• Participates in the Interdisciplinary Care Team (ICT) in conjunction with the SNP CM team, PCP and beneficiary/caregiver
• Assists in using Peak Health’s analytics tools to monitor HRA timeliness, care plan compliance, ICT effectiveness, utilization trends, and quality outcomes
• Serve as a key liaison between SNP Care Management, Peak Health providers, pharmacy, behavioral health partners, and community agencies
• Support escalation and review of high-risk, high-need member cases to ensure appropriate interventions, community resource connections, and care plan adjustments
• Assist Peak’s Quality Management and Compliance teams to support Stars improvement, HEDIS performance, utilization management coordination, and audit readiness
• Support escalation and review of high-risk, high-need member cases to ensure appropriate interventions, community resource connections, and care plan adjustments

Lead Care Manager

Auditor

• Reviews and accurately interprets medical record documentation from all hospital accounts
• Assigns hospital codes to a variety of patient classes (i.e. ED, OBS, SDC, etc.)
• Maintains and enhances current levels of coding knowledge through quality review and attendance at clinical in-services
• 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.

Hospital Coding Specialist II – Technology Auditor

• Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers.
• Will also oversee or perform the overall auditing and education plans for the Coding staff.
• Responsible for the overall auditing and education plans for the Coding staff.
• This position will perform coding quality audits, provide ongoing feedback and education.

Coding Auditor-Educator

Call Center Representative

• Responsible for scheduling, cancelling, rescheduling, and registering outpatient visits and procedures for multiple ambulatory clinics
• Obtain and verify patient guarantor information at least once a year
• Schedules and registers patients/customers based on scheduling guidelines
• Obtains and collects all necessary information from the patient/customer
• Identifies and communicates need for scheduling modifications
• Notifies appropriate personnel of any scheduling change in a timely fashion
• Receives and responds to patient and staff needs and complaints
• Consults with referring physician’s office to ensure written and/or electronic orders exist
• Completes Workques in a timely fashion along with daily tasks

Scheduler – Call Center

Director

• Leads the activities of the clinical nutrition department including the nutritional care of patients.
• Responsible for planning, organizing, developing, and directing nutrition guidelines, initiatives, and operations for Clinical Nutrition
• Promotes nutritional education for diabetic patients through ongoing provider education
• Collaborates with individuals in both the inpatient and outpatient areas to coordinate care of patients across the health care continuum.

Director of Clinical Nutrition

Supply Chain

• Ensures all materials are received, stored, and distributed properly
• Inputting and retrieving data in the materials management module
• Assists and communicates with Buyers and/or Supply Chain leadership
• Maintain understanding of supply automation systems
• Handles supply requisitions and delivers supplies throughout the hospital
• Assists hospital employees with ordering supplies
• Conducts physical inventories and cycle counts
• Operates material handling equipment safely

Supply Chain Technician

• Directs the staff and operations of the coding department.
• Holds staff accountable for achieving plans and performance targets.
• Develops a high-performing team that provides superior project management skills.
• Maintains strong understanding of coding metrics, leadership skills, project management, and leads the team in building plans to support operational departments.
• Ensures compliance with government and commercial coding regulations and standards.
• Leads the coding departments strategic plan objectives and operational goal setting and execution.
• Continuously evaluates the effectiveness and efficiency of operations and implements or proposes optimization or transformation efforts.
• Develops and maintains strong relationships with clients/providers.
• Provides regular revenue management reports to clients, providers, and management.
• Manages operational expenses in accordance with the budget.
• Works collaboratively with coding department leadership to meet strategic goals and develop guidelines and procedures.

Manager, Enterprise Coding

• Responsible for strategic leadership, growth, and program development for surgical and non-surgical specialties.
• Collaborates with physicians and clinical leadership to execute effective initiatives, plans and tactics.
• Develops, implements, and monitors clinical program goals for inpatient and ambulatory settings.
• Provides leadership and strategic vision to operationalize standard processes relating to clinical programs.
• Collaborates with leadership to develop departmental/clinic budgets and reviews budgetary compliance.

Director, Women's & Children's Services

Pharmacist

• Perform drug utilization review for initial determinations and/or appeals for ASO clients and Medicare Advantage plan.
• Collaborate as an integral member of the pharmacy team.
• Serve as subject matter expert for pharmacy utilization management.
• Ensure timely execution of all drug reviews in compliance with accreditation and regulatory standards.
• Work with Medical Director and Clinical Formulary team to review specialty medications requiring a consult.