Provides care in the individual and group setting  Works with primary care providers throughout the organization to provide education and monitoring services for all referred patients  Works closely with the staff and providers to identify patients that require education and monitoring services  Manages a caseload of patients independently  Assesses patients for their learning needs, follows them appropriately and documents in the patient electronic medical record  Keeps abreast of new developments in care  Provides staff education for nurses or others at various sites as requested  Utilizes the curriculum developed for the care of patients  Provides professional and courteous care to patients  Provides support, teaching, and ongoing management services to patients  Provides self-management education in both group and individual visits  Performs other similar and related duties as required or directed