UAS Certified RN licensed in the state of NY. Conduct face to face assessments of members' functional status, medical, behavioral, psychosocial and community resource needs. Provides the Interdisciplinary Care Team (ICT) with assessment information and acts as facilitator to ensure that members' needs are met. Develop an ICP/PCSP based on members' clinical, behavioral, an

Works with members, providers, and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on