Assess and evaluate the needs of our most complex members, acting as the clinical coordinator collaborating with members, caregivers, providers, multi-disciplinary team, and health care and community resources through a variety of assessments to identify areas of (medical, financial, environmental, health insurance benefit, psycho-social, caregiving) concerns and potential gaps in care utilizing the most appropriate resources to support members' needs. Assess the needs of members and align them with the appropriate member of the care team (wellness team, registered dietitian, social worker, community health workers).Act as the member's advocate and liaison by completing or facilitating interventions with providers and/or private, non-profit, and governmental agencies.