• Develops, assesses, and facilitates complex care management activities for primarily physical needs members • Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs • Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs • Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals • Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators