Nutritionist, Population Health Case Management, Glen Burnie

Job Description

Position Summary:

The Nutritionist will play a key role in supporting population health initiatives by providing nutrition counseling and education as part of a multidisciplinary case management team. This position will focus on improving health outcomes, reducing hospital readmissions, and enhancing chronic disease management through evidence-based nutrition interventions.  This position will also support the health and wellness initiatives provided through case management to eligible UMMS employees.  The role involves both in-person consultations and virtual support for patients, ensuring accessibility and continuity of care.

Key Responsibilities:

Patient-Centered Nutrition Care:

•    Conduct comprehensive nutrition assessments for patients identified through case management referrals.

•    Develop and implement individualized nutrition care plans in collaboration with the case management team.

•    Provide virtual and in-person nutrition counseling to patients with chronic conditions (e.g., diabetes, cardiovascular disease, obesity, kidney disease).

•    Address food insecurity and connect patients with community resources, meal programs, and benefits such as SNAP/WIC.

Care Coordination & Team Collaboration:

•    Work closely with nurses, social workers, care coordinators, and physicians to align nutrition strategies with overall care plans.

•    Participate in interdisciplinary case conferences to discuss high-risk patients and recommend nutrition interventions.

•    Assist in developing and implementing population health strategies related to nutrition, including health education initiatives.

Data & Quality Improvement:

•    Track patient progress, document interventions, and measure outcomes related to nutrition support in electronic health records (EHR).

•    Use data analytics to identify trends, gaps in care, and opportunities for targeted nutrition interventions.

•    Contribute to quality improvement initiatives to enhance patient engagement and improve clinical outcomes under value-based care models.

Uses knowledge and skills to identify and re-evaluate nutrition risk throughout patients stay; independently performs the nutrition care process, including nutrition assessment, diagnosis, intervention, monitoring, and evaluation, specific to age and medical status. In collaboration with team, develops an interdisciplinary nutrition plan of care for patients at high risk. Modifies plan of care according to own professional knowledge.

Discusses plan of nutrition care (e.g. nutrition support, education, etc.) with patient/and or family; provides medical nutrition therapy as indicated; electronically documents nutrition plan of care and education provided.

Provides guidance and training to nutritionists, dietetic technicians and interns in conducting nutrition risk assignments, assessments, and in providing nutrition care to patients.

Collaborates with clinical nutrition team members, as well as outside dietitians and vendors, to facilitate smooth transition and continuity of care for patients, including upon hospital discharge.

Actively contributes to teamwork and achievement of department goals; attends staff meetings and may support community events. Cooperates with peers and is flexible with cross coverage. Interacts with others in a polite, courteous, and supportive manner in alignment with UMMC standards of behavior.

Work Environment:

Hybrid role with a combination of remote telehealth sessions and in-person consultations at healthcare facilities or community sites.

May require occasional travel for onsite meetings, community events, or patient visits.

Department - UMMS Population Health Services Organization

Reports to the Manager of Population Health Case Management