Clinical Optimization Specialist - Signature Service Line (Morgantown)

Clinical Optimization Specialist

The Clinical Optimization Specialist acts as a key clinical and operational resource focused on enhancing provider documentation accuracy, ensuring revenue integrity, and identifying critical acuity indicators to optimize revenue cycle performance. This role will report to the Heart and Vascular Assistant Vice President of Finance and partner directly with Revenue Cycle teams, as well as collaborate with HVI physicians, APPs, and IT analysts to optimize documentation workflows and clinical templates within Epic's EMR. The role will ensure that documentation aligns with evolving coding requirements, accurately reflects patient acuity, and supports the strategic goals of the Heart & Vascular Institute system wide. The position is MondayFriday, 8-hour days, with the potential to participate in inpatient or clinic coverage up to two days per month. Additional clinical work, upon approval, may be completed on a per diem basis provided it does not impact the standard weekday schedule.

Minimum Qualifications:

Education, Certification, and/or Licensure:

1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
OR
Must possess current Radiography License as required by state board where services will be provided:MD: Radiographer License through Maryland Board of PhysiciansOH: Radiographer License through Ohio Department of HealthPA: No state licensure requiredWV: Radiography License through West Virginia Medical Imaging and Radiation Therapy Technology Board AND Must be Nationally certified as defined by location where services will be provided:MD: Registered Radiography Technologist by the American Registry of Radiologic Technologists (ARRT) upon hireOH: Registered Radiography Technologist by the American Registry of Radiologic Technologists (ARRT) upon hirePA: Registered Radiography Technologist by the American Registry of Radiologic Technologists (ARRT) within Six (6) months of graduation from Medical Imaging program.WV: Registered Radiography Technologist by the American Registry of Radiologic Technologists (ARRT).

Experience:

1. Five (5) years of relevant clinical experience within a discipline aligned to the Heart & Vascular Institute (cardiology, CT surgery, vascular surgery, or critical care preferred)

Preferred Qualifications:

Experience:

1. Experience with clinical documentation improvement (CDI) programs, coding review, or documentation optimization.

2. Experienced in EPIC templates and workflows

3. Prior involvement in process improvement or workflow optimization.

4. Familiarity with cardiovascular or procedural specialties.

Core Duties and Responsibilities:

Documentation Optimization & Coding Support

1. Partner with System Coding and HVI AVP of Finance to identify documentation gaps affecting acuity of care, reimbursement, and overall revenue performance.

2. Review evolving coding requirements and ensure HVI providers remain informed proactively of necessary documentation elements to support accurate acuity and prevention of payor denials.

3. Serve as a subject-matter expert and resource for providers regarding documentation standards, coding questions, template utilization, and best practices

4. Participate in chart audits and feedback loops to identify trends, opportunities for improvement, and systemic issues requiring workflow changes.

Collaboration & Systems Integration

5. Collaborate closely with System Revenue Cycle leadership to support enterprise-level coding initiatives and standardization efforts.

6. Work with physician and APP leaders to ensure alignment with service line documentation goals and quality expectations.

7. Partner with IT and clinical informatics teams to optimize Epic documentation templates, smart phrases, and workflows to incorporate required documentation points.

8. Support ongoing training and communication to HVI providers related to documentation updates, coding changes, and compliance requirements.

Clinical Responsibilities

9. Maintain clinical competency by possibly providing direct patient care in clinic or inpatient settings up to two days per month.

10. Optional additional per diem coverage may be performed when mutually agreed upon and not conflicting with the MondayFriday documentation role.

Provider Liaison Role

11. Act as the primary liaison between HVI providers and System Revenue Cycle teams to ensure bidirectional communication, issue resolution, and documentation improvement support.

12. Facilitate case-based discussions or education aimed at helping clinicians understand how documentation drives coding and revenue accuracy.

13. Communicate coding trends, updates, and opportunities to service line leadership.

Physical Requirements:

1. May need to sit for extended periods of time

Working Environment:

1. Standard office equipment

Skills and Abilities:

1. Demonstrated knowledge of clinical documentation requirements, patient acuity indicators, and reimbursement practices

2. Proficiency in Epic EMR, including documentation tools, smart phrases, and workflow navigation.

Strong attention to detail, excellent communication skills, and the ability to educate and influence clinical peers.

3. Ability to work effectively with multidisciplinary teams including Revenue Cycle, IT, Finance, and physician leadership.

4. Strong Excel, database, and PC skills.

5. Strong organizational skills and attention to detail

6. Ability to multi-task and work in a challenging fast paced environment

7. Excellent written and verbal communication skills

8. Independent worker and analytical thinker with ability to conduct research, data analysis, and resolve complex problems

Additional Job Description:

Scheduled Weekly Hours: 40

Shift: Exempt/Non-Exempt: United States of America (Exempt)

Company: WVUH West Virginia University Hospitals

Cost Center: 132 WVUH HVI Admin

Address: 1 Medical Center Drive Morgantown West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively WVUHS) is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.