• Perform telephonic member outreach and/or face-to-face encounter utilizing key motivational interviewing skills • Perform departmental assessments and evaluate member holistically to identify needs, health goals, and barriers to wellness • Develop a member-specific plan of care, implement member-specific care manager interventions, and revise plan of care as needed • Complete documentation in applicable platform according to departmental policy and regulatory standards • Provide targeted health education, proactive strategies for condition management, and communication with key providers and vendors • Collaborate with member/caregiver and the facility care team to coordinate a safe transition to the next level of care • Collaborates and liaises with the interdisciplinary care team to improve member outcomes • Maintain professional growth and development through self-directed learning activities