Registered Dietitian Care Coordinator - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)
Denver HealthAbout the role
We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Managed Care Administration* This is a hybrid role with a weekly in-office requirement.
Job Summary
Under general supervision, the Registered Dietitian is responsible for facilitating and coordinating the care delivered to an assigned
group of members using multidisciplinary and member/family collaboration to ensure quality and cost effective outcomes are
delivered within appropriate care coordination parameters. Coordination involves assessment of care needs, planning, support,
and evaluation of member care and related outcomes. Activities to be performed are screening and assessment of medical,
behavioral health and social determinants needs and gaps in care, collaboration with the Member to develop a care plan with
SMART goals, scheduled outreach to support member in achieving their goals and supporting the Members self-efficacy to navigate
systems. Registered Dietitian communicates closely with the Member's care team inclusive of: the Member, designated health
representatives, primary care provider, behavioral health providers and other care coordinators involved with the Member's care.
Encounters occur face to face, telephonically, and electronically with members in clinic and in other community-based settings.
Ensures appropriate nutritional counseling is provided to members. Provides support to Care Management in role of dietitian on
an interdisciplinary care team.
Essential Functions:
- Utilizes Care Coordination Processes
* Systematically collects focused data relating health needs and concerns of member, group, or population.
* Establishes and maintains member-centered relationships.
* Analyzes assessment data to determine opportunities for health promotion, health maintenance or health related problem needs and statements.
* Identifies and executes evidence-based interventions to support the Member in achieving their health goals.
* Identifies and works towards expected outcomes in a plan of care individualized for a specific member, group or population.
* In collaboration with the Member, develops a care plan that identifies strategies and alternatives to attain expected outcomes. Utilizes competent, evidence based, telephone encounters and electronic communications according to regulatory requirements and standards, as well organizational policies and procedures.
* Conducts systematic evaluation of outcomes of care coordination in relation to structures and processes prescribed by plan.
* Documents in readable, understandable language according to professional, regulatory, and agency standards.
* Documents and disseminates results of care to member, caregivers, and others involved in the care or situation, as appropriate, in accordance with contractual requirements, state and federal laws, regulatory requirements, and Denver Health policy. (25%) - Provide Care Coordination Services
* Coordinates the delivery of care within the clinic setting, throughout the organization, and across health care settings.
* Provides relevant information across the care system, within Denver Health and with other healthcare systems and payers when member care is transferred between and among different specialties and/or within one or more organizations.
* Provides information to the health care team including the member, family, and caregiver regarding available resources and benefits for health care services that ensures member choice and safe, timely transition.
* Serves as point of contact within and among healthcare services and organizations.
* Coordinates community resources.
* Assures designation of primary responsibility among team members for each aspect of care plan, avoiding duplication and fragmentation.
* Facilitates continuity of care using the multidisciplinary collaboration, and coordination of all appropriate healthcare services and community resources across the care continuum.
* Orients member/caregiver to health care delivery system, services, access, and resources. (25%) - Health Teaching and Promotion
* Identifies barriers to goals and strategies to address.
* Provides personalized education for optimal wellness.
* Encourages preventative care such as immunizations and cancer screening.
* Promotes appropriate utilization of resources.
* Assists and educates caregiver when member is unable to participate.<
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