• Job Description

  Req#: 4054

  Overview

  Now is the time to join us!

  We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

  Responsibilities

  Who are you?

  Registered Dietitian Case Manager (RDN-CM) is responsible for providing comprehensive nutrition care and case management services to individuals with complex medical and social needs. This role integrates evidence-based nutrition practice with case management principles to support optimal health outcomes. The RDN-CM collaborates with interdisciplinary teams, patients, families, and community resources to ensure coordinated and patient-centered care.

  In this role you will wear many hats, but your knowledge will be essential in the following:

  • Contact targeted members for health promotion and restoration by using national care guidelines to compare patient’s current level of care with industry standards.
  • Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health; create an individual care plan for each patient; provide close follow-up with patients actively managed.
  • Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs.
  • Evaluate and make referrals for case management, prenatal program, or pharmacology review as indicated.
  • Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients.
  • Track groups of high-risk members and interventions to show overall health improvement within the organization.
  • Be able to meet productivity, quality, and turnaround time requirements daily, weekly, and monthly.
  • Ability to meet productivity, quality, and turnaround times daily.
  • Ability to pass external audits to include URAC and NCQA.
  • Maintain HIPPA compliance per company’s policy and procedures.
  • Maintain confidentiality and minimum requirement rules.
  • Complete all required yearly training per company’s expected period.

  You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

  Qualifications

  What you bring to the Personify Health team:

  In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

  • Registered Nurse: Graduation from an accredited RN Program and possession of a current United States RN. May require additional licensing as business needs change.
  • Registered Dietitian Nutritionist (RDN) Education: Bachelor's degree in nutrition, Dietetics, or a related field from an accredited program. Master’s degree preferred. Minimum of 3 years of clinical nutrition experience
  • Prior experience in case management, coordinating wellness programs, or an equivalent combination of education and experience.

  You also take pride in offering the following Core Skills, Competencies, and Characteistics:

  • Basic computer literacy
  • The ability to work on multiple screens, and proficient typing skills.
  • Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook Excellent verbal and written communication skills
  • Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
  • Ability to work independently and utilize written resources to problem solve.

  After training with our training department and 1.5 months ramp (3 months total), must have and be able to work in:

  • Advanced your skills in basic computer literacy and have the ability to work in Teams on and off camera, SharePoint, Drives as needed, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Phone system with headset, Smartsheet—there may be additional programs as it relates to particular job duties
  • Knowledge of medical claims and ICD-10, CPT, HCPCS coding
  • Excellent verbal and written communication skills for upward and downward conversations

  No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

  Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

  In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $36 to $38 per hour. Note that compensation may vary based on location, skills, and experience.

  PLEASE NOTE THIS POSITION IS NOT ELIGIBLE FOR BENEFITS.

  We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

  #WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded

  Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

  Application Deadline: Open until position is filled.

• About the company

  See how Virgin Pulse's employee well-being solution helps employees create habits that matter so they can be their best at work and at home.

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