Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate care Utilize both company and community-based resources to establish a safe and effective case management plan for members Collaborate with member, family, and healthcare providers Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services Keep the member out of the hospital by supporting regular visits to their primary care physician Keep member actively engaged with their primary physician Support the member to ensure pick - up of their Rx Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for members and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team Document all member assessments and referrals provided. Accountable to understand role and how it affects utilization management benchmarks and quality outcomes You’ll need to be flexible, adaptable and, above all, patience in all types of situations. Engage members either face to face or telephonically to assist with closing gaps in care, linking to necessary services and providing education about their health  Adhere to detailed, specific documentation requirements in the member’s health record Proactively engage the member to manage their own health and healthcare using Motivational Interviewing Skills As needed, help the member engage with mental health and substance use treatment Work collaboratively with the interdisciplinary care team to ensure an integrated team approach  Utilize strong skill sets of managing multiple tasks at a time, being self-motivated, driven toward quality results, managing time well, being very detailed oriented and organized, work well in a team and on your own, and ability to manage multiple deadlines. Performs other duties as assigned