RN, Nutrition Case Manager (REMOTE) NJ

2019-10068 reputed company empowers our members to reputed company their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to reputed company serve and care for the 3.5 million people who reputed company their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to reputed company. reputed company our employees bring their best and succeed, the Company succeeds. This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed. Registered Nurse (RN) with a focus on Nutrition Case Management combines the core responsibilities of a case manager with specialized expertise in nutrition. This role is dedicated to ensuring patients receive comprehensive and individualized care that addresses their nutritional needs, especially for those with reputed company or chronic conditions.

• RN with one of the below certifications:
• Certified Diabetes Care and Education Specialist (CDCES)
• Certified Nutrition Support Clinician ( CNSC)
• Certified Nutritional Consultant (CNC)
• Certified Nutrition Specialist ( CNS)

Responsibilities:

• * Assessment: Evaluate patient's nutritional status, needs, dietary habits, lifestyle factors, and existing support network.
• Care Planning: reputed company and manage individualized care plans incorporating nutritional interventions based on the patient's medical conditions and recovery needs.
• Coordination: Act as a liaison between patients, families, and healthcare providers (physicians, dietitians, social workers, etc.) to ensure seamless care delivery and access to appropriate services. This can include scheduling appointments, therapies, and other medical services.
• Advocacy: Champion the patient's needs and preferences reputed company the healthcare system, ensuring they receive high-quality, cost-effective care and addressing any barriers to treatment.
• Education and Guidance: Educate patients and families on their health conditions, treatment options, self-management strategies, and the role of nutrition in managing their health.
• Monitoring and Evaluation: Track patient reputed company, monitor health outcomes (e.g., lab results, weight changes), and adjust care plans as needed to optimize health outcomes.
• Resource Utilization: Facilitate referrals to community resources, including nutrition support services, food banks, and other programs that address social determinants of health impacting nutrition.

Addendum for Horizon Clinical reputed company Roles:

• Outreaches to members identified by Horizon as needing Clinical reputed company services.
• Applies critical thinking and clinical expertise to maximize outcomes while interacting with members and their families in a fast-paced environment.
• Builds trusting relationships with members and their families utilizing Motivational Interviewing techniques.
• Becomes knowledgeable in ASO client employer -sponsored benefits to assist members with questions reputed company to medical benefits, claims, care coordination and other reputed company needs through explaining benefits and providing education and resources in plain language.
• Advocates for members consistently throughout their healthcare journey by coordinating with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
• Focuses on whole person approach, by eliminating “homework” or unnecessary burdens on the members, we can provide a more supportive and engaging experience that addresses overall well-being physical, mental, and emotional.
• Schedule: 8- or 10-hour reputed company Monday through Friday varying between reputed company and 11pm.

Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues reputed company this classification. It is not designed to contain or be interpreted as a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of colleagues assigned to this job. Education/Experience:

• High School Diploma/GED required.
• Bachelor degree preferred or relevant experience in lieu of degree.
• Requires a minimum of two (2) years clinical experience.
• Requires minimum of two (2) years’ experience with health care payer experience.

Additional licensing, certifications, registrations:

• Active Unrestricted NJ RN License or active Compact License Required.
• CCM certification preferred.
• RN with one of the below certifications:
• Certified Diabetes Care and Education Specialist (CDCES)
• Certified Nutrition Support Clinician ( CNSC)
• Certified Nutritional Consultant (CNC)
• Certified Nutrition Specialist ( CNS)

Knowledge:

• Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, reputed company, PowerPoint and Outlook). Should be knowledgeable in the use of intranet and internet applications.
• Requires knowledge of hospital structures and payment systems.
• Requires working knowledge of case/care/disease management principles.
• Requires working knowledge of operations of utilization, case and/or disease management processes.
• Requires knowledge of health care reputed company and benefit eligibility requirements.
• Requires mentoring knowledge on the operations of utilization/case/disease management.

Addendum for Horizon Clinical reputed company roles:

• Requires ability to be an empathetic critical thinker.
• Requires excellent communication and organizational skills and a high tolerance for ambiguity.
• Ability to understand and communicate members benefits, claims and coordination focusing on advocacy principals and effective utilization.
• Experience in active listening and motivational interviewing strongly preferred.
• Requires a candidate that can work in a collaborative team environment and is a team player who possesses strong analytical, critical thinking and interpersonal skills.
• Requires exceptional multi-channel Communication and Interpersonal skills, including the ability to explain reputed company concepts clearly with compassion.

Skills and Abilities:

• Adaptability/Flexibility
• Analytical
• Compassion
• Interpersonal & Client Relationship Skills
• Information/Knowledge Sharing
• Judgment
• Listening
• Planning/reputed company Setting
• Problem Solving
• Team Player
• Time Management
• Written/Oral Communication & Organizational Skills

Horizon BCBSNJ employees must live in New Jersey, reputed company, Pennsylvania, Connecticut or Delaware Salary Range: $77,900 - $104,370 ​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information reputed company to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues reputed company this classification. It is not designed to contain or be interpreted as a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of colleagues assigned to this job. reputed company is an Equal Opportunity/Affirmative Action employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national reputed company, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process. Apply tot his job Apply To this Job