MR

Msn Nadine Delia Mha Rn

Director Of Appeals And Quality at Horizon Healthcare Services of New Jersey

Nadine Delia has a extensive work experience in the healthcare industry. Nadine worked at Horizon Blue Cross Blue Shield of New Jersey from 2013 to present. During their time there, they served as the Director of Appeals and Quality, where they led and directed the receipt, investigation, and response of Utilization Management Appeals, as well as oversaw grievances related to the quality of care for services rendered by network providers. Prior to that, they held positions as the Manager of Inpatient Case Management, Supervisor of Inpatient Case Management, and Inpatient Case Manager.

Before joining Horizon Blue Cross Blue Shield, Nadine worked at Barnabas Health from 2008 to 2013 as an RN in the Medical/Surgical PCU Telemetry Department. Nadine'sresponsibilities included providing individualized age-specific professional care to patients, coordinating diagnostic testing, providing pre/post-op education, assuming charge nurse and preceptor responsibilities, and collaborating with Case Managers to coordinate patient care.

Additionally, from 2009 to 2010, Nadine worked as a per diem RN at VNA of Central Jersey, where they assessed, planned, provided, and documented nursing care for designated patients in accordance with the physician's plan of care and agency policies and procedures.

From 2000 to 2008, Nadine worked at VNA of Central Jersey as an Administrative Office Manager. In this role, they assumed overall administrative responsibility for the Toms River Regional office, served as a preceptor for new ancillary staff, received and triaged incoming phone calls, prioritized and organized referrals for new patients, and coordinated nursing schedules for admissions/revisits.

Nadine Delia MHA, MSN, RN completed their education in a chronological order. Nadine first attended Kaplan University from 2009 to 2011, earning a Bachelor of Science in Nursing (BSN) with a focus on Nursing Science. Following this, from 2014 to 2016, they attended the University of Phoenix and obtained a Master's Degree in Health/Health Care Administration/Management (MHA). With their educational background, Nadine holds both a BSN and an MHA, along with their nursing credentials as a Registered Nurse (RN).

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Timeline

  • Director Of Appeals And Quality

    February, 2022 - present

  • Manager Inpatient Case Management

    May, 2018

  • Supervisor Inpatient Case Management

    October, 2016

  • Inpatient Case Management

    July, 2013