Case Management Registered Nurse Supplemental Health CareCase Management Registered NurseSyracuse, NYFull timeThis traveler-friendly facility is known for its cutting-edge technology, supportive environment, and diverse learning opportunities, making it an excellent place to grow your career and even extend your contract. Job Description:Supplemental Health Care is seeking experienced Registered Nurses (RNs) for an exciting travel opportunity at a Level 1 teaching hospital in Syracuse, New York.
Targeted Case Manager Liberty_ResourcesTargeted Case ManagerSyracuse, NYFull timeWe’re committed to building a diverse workforce that values contributions of all team members and work to recognize cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and how they apply to provision of positive health outcomes. The Targeted Case Manager (TCM)) is responsible for providing care coordination and resource linkage for clients served by Liberty Resources’ Integrated Healthcare clinic.
Case Manager Asylum Neighborhood Association for Inter-Cultural AffairsCase Manager AsylumNew YorkRole Summary : The Asylum Case Manager Supervisor plays a vital role in supporting the Director of Social Services, primarily focused on the unique needs and challenges faced by asylum seekers. This position involves overseeing day-to-day operations of the Social Services Department, ensuring the provision of comprehensive support and services to asylum seekers under the guidance of the Director of Social Services.
Case Manager I New York State Thruway AuthorityCase Manager ISyracuse, NYwww.nycourts.gov/careers/UCS5.pdf), cover letter and resume by email to 5JDJobs@nycourts.gov or mail to: DONALD C. Please note: State agencies that contact job applicants do not usually request personal or financial information via text message or over the phone in connection with your response to a job posting.
Behavioral Health Case Manager I - New York Medicaid Elevance HealthBehavioral Health Case Manager I - New York MedicaidNew YorkRequires MA/MS in social work, counseling, or a related behavioral health field or a degree in nursing, and minimum of 3 years clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. The Behavioral Health Case Manager I will be responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs.
NewCase Manager LorettoCase ManagerNorth Syracuse, New York$27.24–$35.40 / hourFull timeMaintains accurate, complete and timely documentation on new admissions, including social history, advance directive tracking sheet, family information, funeral arrangements, and progress notes. Outstanding interpersonal and communication skills including the ability to communicate effectively with clients, residents, and families from diverse backgrounds who may have physical, sensory and mental impairments.
Program Case Manager SUNY Upstate Medical UniversityProgram Case ManagerSyracuse, NYJob Summary: SUNY Upstate Pediatrics is seeking a Program Case Manager who will serve as an important member of the Patient Services Team, working with the medical team to provide excellent patient-centered care to address social determinants of health which affect health, functioning and quality of life outcomes, working with patients enrolled in the program with the goal of providing resources and referrals to address health disparities and inequities. Job Responsibilities: • Complete social determinants of health assessments, and risk assessments with all enrolled patients and document an individualized plan with patients to address identified issues and provide follow-up assistance in reaching goals.
Case Manager IAVACase ManagerNew YorkLocate and engage with public agencies on the state and federal level, with other nonprofits, various Veterans Affairs sites and departments to identify employment, supportive and mental health services, housing resources and emergency financial assistance. Since its launch in late 2012, our Case Managers have helped more than 8,000 veterans and family members get on track to meeting their goals through free and confidential support and connections to highest quality resources and benefits.
Workforce Development Case Manager Center for Community AlternativesWorkforce Development Case ManagerSyracuse, NYQualifications: We seek talented, dedicated individuals who possess a strong commitment to CCA’s mission, including those with relevant personal experience in terms of recovery and/or criminal conviction; Experience working with adults from diverse cultural backgrounds who are impacted by the criminal legal system, preferred; Experience providing employment services, preferred; BA/BS in public administration, health, social work, criminal justice preferred; Bi-lingual (English/Spanish), a plus; Excellent communication, writing and computer skills, required; valid NYS Driver’s License, access to registered and insured vehicle, and transporting participants in own vehicle, required; Occasional travel to out of town/state conferences and meetings. Provide employment and career support to program participants helping them to obtain, retain, and advance in employment, complete vocational training, earn industry recognized credentials, increase their educational advancement and access program and community services.
Social Security Disability Case Manager MindsetSocial Security Disability Case ManagerNew YorkThe ideal candidate will be responsible for assisting clients with the application process, gathering necessary documentation, advocating on behalf of clients, and ensuring that all claims are processed accurately. Position Overview: We are seeking a dedicated and compassionate Social Security Disability Claims Case Manager to join our team.
Mental Health Residential Case Manager OCOMental Health Residential Case ManagerFulton, New YorkJoin our Mental Health Transitional Living Program and help individuals with serious mental illness build independence, stability, and everyday life skills. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
MAC Youth Case Manager Catholic Charities of Onondaga CountyMAC Youth Case ManagerSyracuse, New YorkBachelor’s degree in Human Services or related field preferred, 1–3 years of experience working with youth, teens, individuals who speak English as a new language, refugees, and individuals from diverse backgrounds; a combination of education and experience. Assist youth program staff with academic support activities such as facilitating communication between schools and families, arranging homework assistance, tutoring, English classes and Regents test preparation to promote academic success of the refugee students.
FFT CW Case Planner, II The Salvation Army USAFFT CW Case Planner, IISyracuse, NYDevelop and implement individualized service plans in collaboration with families, Department of Social Services (DSS), and community providers, using FFT-CW strategies to promote behavioral change and family preservation. Provide FFT-CW services through regular client engagement, family therapy sessions, and required contacts to support family stability and positive youth outcomes.
FFT CW Case Planner, II The Salvation Army Eastern TerritoryFFT CW Case Planner, IISyracuse, New YorkFull timeDevelop and implement individualized service plans in collaboration with families, Department of Social Services (DSS), and community providers, using FFT-CW strategies to promote behavioral change and family preservation. Provide FFT-CW services through regular client engagement, family therapy sessions, and required contacts to support family stability and positive youth outcomes.
Clinical Case Manager SUNY Upstate Medical UniversityClinical Case ManagerSyracuse, NYMinimum Qualifications: NYS licensed RN (or eligible), Bachelor''s degree in Nursing or a healthcare-related field, plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care RN/case management experience OR Associates degree in Nursing and five (5) years acute care RN or acute care, transitional care, or chronic care RN/case management experience required. Job Summary: The Clinical Case Manager will facilitate the continuum of care for an assigned number of cases by managing, coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services, and financial goals.
PM&R Clinical Case Manager SUNY Upstate Medical UniversityPM&R Clinical Case ManagerSyracuse, NYMinimum Qualifications: NYS licensed RN (or eligible), Bachelor''s degree in Nursing or a healthcare-related field, plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care RN/case management experience OR Associates degree in Nursing and five (5) years acute care RN or acute care, transitional care, or chronic care RN/case management experience required. Job Summary: The PM&R Clinical Case Manager''s primary responsibility is to facilitate patient care across the continuum of an assigned number of cases by managing, coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services and financial goals.
Acute Care Hospital at Home Case Manager SUNY Upstate Medical UniversityAcute Care Hospital at Home Case ManagerSyracuse, NYAcute Care Hospital at Home Case Manager Syracuse Management & Professional Registered Nurses Full-time Opening on: Apr 22 2026 Acute Hospital Care at Home State of New York TH Staff Associate, NSSL4 89337 UUP (State University Professional Services Unit) Add to favorites View favorites Job Summary: The Acute Care Hospital at Home Case Manager will facilitate the continuum of care for an assigned number of cases by managing, coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services and financial goals. Minimum Qualifications: NYS licensed/registered (or eligible) RN, Bachelor''s degree in Nursing or healthcare related field, plus minimum of three (3) years acute care RN or acute care, transitional care, or chronic care RN/case management experience required.
Aging Services Specialist - Case Mgmt Tioga Opportunities, Inc.Aging Services Specialist - Case MgmtNew YorkThe Aging Services Specialist is responsible for performance of case management activities for non-Medicaid clients over 60 years of age, consisting of screening, assessment, care planning, determining eligibility for program subsidies, arranging and authorizing service delivery, services follow-up, and client monitoring, reassessment, and discharge. Screens and conducts face-to-face in-home assessments and reassessments to identify an individual’s problems and care needs in the major functional areas, including information necessary to determine the individual’s functional level and to identify unmet care needs.
CTI Case Manager AccessCNY INCCTI Case ManagerSyracuse, NY$24–$26 / hourProvide CTI services for assigned youth, developing relationships with assigned youth/families, developing relationships with hospitals and service providers, following the fidelity of the CTI model, completing assessments, progress notes, and reports, as required. One year of experience working with people with developmental disabilities or a mental health diagnosis or case management experience working with youth and families is preferred.
Nurse Case Manager, Enhanced Step-Down **Sign-On Bonus** AccessCNY INCNurse Case Manager, Enhanced Step-Down **Sign-On Bonus**Syracuse, NY$37.45–$40.01 / hourWe are looking for a proactive employee to provide monitoring and oversight of participants’ medical care and ensure their health needs are met while enrolled in the Enhanced Step-Down (ESD) Program for CTI-only services and/or the Transitional Residential Setting (TRS). Engage individuals in skill building, offer crisis management, collaborate with other service providers, assist individuals in navigating complex systems and collaborate with informal supports in adherence to the CTI model.
Medical Case Manager I CorVel CorpMedical Case Manager ISyracuse, NYRemote$65,739–$95,264 / yearIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Registered Nurse, Case Manager RNRegistered Nurse, Case ManagerOswego, NY$75,250–$87,138.92 / yearWe can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities. At Nascentia Health, you’ll provide skilled, compassionate care to adults with chronic, acute, or complex medical needs in the comfort of their homes, helping patients maintain independence, improve quality of life, and feel supported in their own environment.
Registered Nurse/Case Manager HonorVet TechnologiesRegistered Nurse/Case ManagerSyracuse, NY$71 / hourAbout the Company: HonorVet Technologies (SDVOSB) provides specialized and high-volume healthcare staffing solutions to hospitals, healthcare systems, clinics, and allied healthcare organizations across the United States. With strong delivery capabilities and rapid turnaround times, we support contract, travel, direct hire, and per-dem staffing needs across nursing, allied health, healthcare IT, and clinical support services.
Case Manager / Care Manager Bond Health StaffingCase Manager / Care ManagerOrange County, NY$50,000–$60,000 / yearThe role of the Care Manager is to deliver the 6 core services in a person-centered manner in order to meet the needs of the individual, the OPWDD valued outcomes, the objectives of the People First Transformation, and the State requirements. The Care Manager provides referral and linkage to benefits and services, and in-person visits with members ranging from monthly to bi-annually dependent on the need of each member.
Case Manager The Salvation Army USACase ManagerSyracuse, NY$24–$25 / hourThey provide individual and family case management, supportive counseling, advocacy, life skills education and referrals to other community and mainstream resources to aid in securing and maintaining safe, affordable housing and a stable living situation for the people we serve in our Community! Professional position includes expectation that a flexible work schedule be maintained according to individual client needs including late afternoon/evening hours as needed.
Case Manager The Salvation Army Eastern TerritoryCase ManagerSyracuse, New York$24–$25 / hourFull timeThey provide individual and family case management, supportive counseling, advocacy, life skills education and referrals to other community and mainstream resources to aid in securing and maintaining safe, affordable housing and a stable living situation for the people we serve in our Community! Professional position includes expectation that a flexible work schedule be maintained according to individual client needs including late afternoon/evening hours as needed.
Medical Case Manager I CorVel Healthcare CorporationMedical Case Manager ISyracuse, NYRemote$65,739–$95,264 / yearPart timeIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
RN CASE MANAGER-HOME CARE, Full Time Oswego HealthRN CASE MANAGER-HOME CARE, Full TimeFulton, NY$35–$41.20 / hourMore than 1,200 employees spread throughout its 17 locations, work for the Oswego Health system, which includes the 164-bed community hospital with a brand new Medical Surgical Unit, a 32-bed state-of-the-art psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community. The health system also operates Oswego Health Home Care, the only hospital-based certified home healthcare agency in the County as well as two outpatient centers, including the Fulton Medical Center, offering urgent care, lab, medical imaging, physical therapy, and occupational health services; and the Central Square Medical Center, offering urgent care, lab, medical imaging, and physical therapy services.
RN Case Manager / Utilization Review Greenlife Healthcare StaffingRN Case Manager / Utilization ReviewSyracuse, NY$130,000–$135,000We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Certification: Basic Life Support (BLS) certification is required; candidates must hold a current certification or be willing to obtain recertification prior to employment.
Case Manager, RN (Per-Diem / Downstate, NY / Field-Based) FreedomCareCase Manager, RN (Per-Diem / Downstate, NY / Field-Based)New YorkBachelor's Degree (BSN) and current NYS License or compact License that is in good standing (OR) associate's degree in nursing with relevant homecare clinical experience. We’re the largest consumer-directed home care agency in NY State and are continually expanding our areas of focus including operations in other states and tech-based innovations.
NewRN Case Manager / Utilization Review GreenLife Healthcare StaffingRN Case Manager / Utilization ReviewSyracuse, NYWe partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Certification: Basic Life Support (BLS) certification is required; candidates must hold a current certification or be willing to obtain recertification prior to employment.
Admissions Coordinator/Case Manager - Onondaga Community College Onondaga Community CollegeAdmissions Coordinator/Case Manager - Onondaga Community CollegeSyracuse, NYLocation: Syracuse, NY Category: Staff (CSEA, PA, MC) Job Type: Full Time - 12 Months Posted On: Tue Jun 30 2026 Job Description: BROAD FUNCTION. This role strategically combines admissions recruitment with comprehensive case management support, implementing proactive .
Pre-Litigation Case Manager, New York TopDog LawPre-Litigation Case Manager, New YorkNew YorkMaintain organized electronic case files, track deadlines and treatment progress, update case management systems, and ensure all pre-litigation milestones are met efficiently. Assist attorneys and claims verification specialists in reviewing and assessing the merits of client’s Personal Injury claims by organizing, reviewing, and summarizing records, documents, and evidence to support early case evaluation and valuation.
NewRegistered Nurse, Home Care Case Manager LorettoRegistered Nurse, Home Care Case ManagerSyracuse, New York$38.51–$43.25 / hourFull timeThe Home Care Case Manager, RN is responsible for providing the highest quality of in-home care, ensuring safety at all times, and acts as a primary support to the Physician, Nurse Practitioner, Director of Clinical Services, and the Home Care Manager. Demonstrates appropriate knowledge and skill while performing quality care and meeting the participant specific needs, as evidenced by appropriate documentation and implementation of Pathways as needed.
OR Case Processing Technician SUNY Upstate Medical UniversityOR Case Processing TechnicianSyracuse, NYIf such information has been requested from you before such time, please contact the Governor''s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov. Will assist in activities for OR inventory replenishment, and unit organization, bin labeling, missing item notification, and product returns.
Utilization Management Manager HealthfirstUtilization Management ManagerHybrid, NY$116,800–$168,810 / yearDevelops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 .
Utilization Management Manager HF Management ServicesUtilization Management ManagerNew YorkDevelops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions. Experience in managed care, case management, identifying alternative care options, and discharge planning across a variety of treatment settings for high risk, complex populations.
Blackstone at Northwestern University - Case Study Competition BlackstoneBlackstone at Northwestern University - Case Study CompetitionNew YorkDepending on the position, you may be required to obtain certain securities licenses if you are in a client facing role and/or if you are engaged in the following: Attending client meetings where you are discussing Blackstone products and/or and client questions; Marketing Blackstone funds to new or existing clients; Supervising or training securities licensed employees; Structuring or creating Blackstone funds/products; and. If you need a reasonable accommodation to complete your application, please contact Human Resources at 212-583-5000 (US), +44 (0)20 7451 4000 (EMEA) or +852 3656 8600 (APAC).
2025 Northwestern University Case Study Blackstone2025 Northwestern University Case StudyNew YorkDepending on the position, you may be required to obtain certain securities licenses if you are in a client facing role and/or if you are engaged in the following: Attending client meetings where you are discussing Blackstone products and/or and client questions; Marketing Blackstone funds to new or existing clients; Supervising or training securities licensed employees; Structuring or creating Blackstone funds/products; and. If you need a reasonable accommodation to complete your application, please contact Human Resources at 212-583-5000 (US), +44 (0)20 7451 4000 (EMEA) or +852 3656 8600 (APAC).
2025 UPENN Case Study Blackstone2025 UPENN Case StudyNew YorkDepending on the position, you may be required to obtain certain securities licenses if you are in a client facing role and/or if you are engaged in the following: Attending client meetings where you are discussing Blackstone products and/or and client questions; Marketing Blackstone funds to new or existing clients; Supervising or training securities licensed employees; Structuring or creating Blackstone funds/products; and. If you need a reasonable accommodation to complete your application, please contact Human Resources at 212-583-5000 (US), +44 (0)20 7451 4000 (EMEA) or +852 3656 8600 (APAC).
Sr Manager, Digital Product Management, Embedded Systems Carrier CorporationSr Manager, Digital Product Management, Embedded SystemsEast Syracuse, NY$117,500–$234,500 / yearUnified platform leadership: Own product requirements for next-generation controller and edge-device platforms, ensuring architecture decisions support feature reuse, scalable deployment, regional requirements, and long-term maintainability. Firmware lifecycle & OTA ownership: Define product requirements for device management, version governance, release readiness, and over-the-air update capabilities across relevant product lines and connected installed bases.
NewSenior Manager - Product Management Marsh McLennanSenior Manager - Product ManagementNew YorkWe aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. Marsh Risk is a business of Marsh (NYSE: MRSH), a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries.
Global Benefits Management Client Manager Marsh McLennanGlobal Benefits Management Client ManagerNew YorkWe aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. Mercer is a business of Marsh (NYSE: MRSH), a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries.
NewOliver Wyman - Insurance & Asset Management - Engagement Manager Marsh McLennanOliver Wyman - Insurance & Asset Management - Engagement ManagerNew YorkCreating a new platform called “Fulcrum” that enables insurers to migrate from legacy administration platforms to new ones in months instead of years through partnerships with many of the leading insurers, technology providers and Third-Party Administrators. While specific responsibilities will vary based on previous experience the ideal candidate will have the following: 5+ years of relevant experience, ideally with a top-tier strategy consulting firm (or other similar organizations with project-based, team-oriented environments) or Life Insurance company.
NewCare Management Supervisor, RN Crouse HospitalCare Management Supervisor, RNSyracuse, NYThe Supervisor leads the development and optimization of integrated care management workflows, ensuring patients receive coordinated, relationship-based care that improves outcomes, reduces avoidable utilization, and supports long-term disease self-management. This position is responsible for overseeing chronic disease management, care coordination, behavioral health integration, and future care management initiatives that support high-risk patient populations across the continuum of care.
NewProgram Manager of Social Work Rescue MissionProgram Manager of Social WorkSyracuse, New YorkThis role involves supervising, coaching, and developing case management staff through effective recruitment, training, and ongoing support, while maintaining a fully staffed schedule that meets operational needs, including evenings and weekends. The Program Manager of Client Services manages processes and provides direct leadership and guidance to the case management team of Emergency Shelter and Day Center.
Care Manager Liberty_ResourcesCare ManagerOneida, NYFull timeThe Care Manager will identify and address physical, behavioral, and social health needs and establish an integrated care team of service providers and supports to reduce the risk of emergency room visits, hospitalizations and other out-of-home placements. We’re committed to building a diverse workforce that values contributions of all team members and work to recognize cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and how they apply to provision of positive health outcomes.
Direct Service Manager Covenant House New YorkDirect Service ManagerNew YorkReporting to and working closely with the Program Coordinator, the Direct Service Manager is responsible for developing the Resident Advisors and leading their day-to-day tasks at Covenant House New York’s residential programs. Possesses expert knowledge and experience working directly with young people through approaches emphasizing resiliency, strength-based youth development, and trauma-informed care.
Housing Court Navigator, Eviction Diversion Initiative Center for Justice InnovationHousing Court Navigator, Eviction Diversion InitiativeRochester and Syracuse, NYFull timeResponsibilities include but are not limited to : Conduct intakes and maintain a caseload of housing court litigants with pending eviction or displacement matters; Provide individualized, trauma-informed case management and wraparound support, including referrals to rental assistance, subsidies, legal services, public benefits, mental health services, employment resources, and other community supports; Assist tenants in navigating court processes and understand court forms; Serve as a point of contact for tenants, court staff, and partner organizations to help coordinate services and address barriers related to nonpayment of rent, repairs, or other eviction risks; Build and maintain collaborative working relationships with on- and off-site partners, including court administration, legal services providers, housing agencies, and social service organizations; Maintain up-to-date knowledge of local housing programs, rental assistance resources, public benefits, and community-based services; Represent the EDI program in court as needed; Accurately document client interactions, services provided, referrals, and outcomes in centralized case management systems; Support program data collection and reporting requirements; Participate in trainings, meetings, and professional development related to housing court practice and partner initiatives; and. EDI connects litigants to rental assistance and ongoing subsidies, legal services, public benefits, mental health support, employment resources, financial empowerment services, and community-based organizations, while working closely with court partners to identify challenges and improve access to justice.
Social Worker - LCSW Wellbe Senior MedicalSocial Worker - LCSWSyracuse, New York$80,000–$95,000 / yearWellBe’s clinician-led geriatric care teams provide concierge-level medical care and social support in the home as well as delivering and coordinating across the entire care continuum – from chronic care and urgent care in the home to hospital to skilled nursing facility to assisted living to palliative care, to end-of-life care. Partner with community team to refer patients to appropriate no or low-cost community services that support health and independence such as Meals On Wheels (MOW), local Area Agencies on Aging (AAA), Senior & Assistance Programs, and transportation resources.