Director of Clinical Optimization & Documentation Excellence

WVU Medicine; Wheeling (IL); On-site; USD 140,000 - 200,000; Full time

Job summary

WH Wheeling Hospital Inc. seeks a Director of Clinical Optimization to lead programs that improve SOI/ROM/CMI, HCC capture, and risk adjustment across care settings. You will bridge CDI, Coding, Population Health, and IT to ensure accurate patient complexity and value-based reimbursement.

Qualifications include a BSN and an RN license, with 7 years of healthcare leadership and BLS within 30 days. Master’s degree preferred; strong engagement with physicians is essential.

Qualifications

• Bachelor of Science in Nursing or related healthcare field required.
• Current RN license in the service state or multi-state license via eNLC.
• BLS certification within 30 days of hire.
• 7 years of progressive healthcare leadership experience.
• Experience in CDI, Coding, Quality Improvement, Population Health, and Hospital Operations.

Responsibilities

• Develop and oversee the Clinical Optimization Program.
• Improve SOI, ROM, CMI, and HCC capture accuracy.
• Collaborate with CDI and Coding to identify documentation opportunities.
• Standardize physician documentation practices across hospitals.
• Lead RAF accuracy and risk adjustment initiatives.
• Partner with Quality and IT to optimize dashboards and metrics.
• Monitor regional performance metrics and denials trends.
• Engage physicians with education, scorecards, and coaching.

Skills

Leadership

CDI

Quality Improvement

Population Health

Value-Based Care

Physician Engagement

Clinical Documentation

Hospital Operations

Education

Bachelor of Science in Nursing

Master’s degree preferred

RN license

BLS certification

Job description

WH Wheeling Hospital Inc. seeks a Director of Clinical Optimization to lead programs that improve SOI/ROM/CMI, HCC capture, and risk adjustment across care settings. You will bridge CDI, Coding, Population Health, and IT to ensure accurate patient complexity and value-based reimbursement.

Qualifications include a BSN and an RN license, with 7 years of healthcare leadership and BLS within 30 days. Master’s degree preferred; strong engagement with physicians is essential.