Educate patients, families, and communities on the importance of preventative and wellness, health-promoting lifestyle interventions, such as o immunizations, o promotion of health screenings, o smoking prevention and cessation, o nutritional counseling, o obesity reduction and prevention, o increasing physical activity, o substance use prevention/early intervention and harm reduction and o promoting independence and skill development related to disease self-management and self-administration of medications. Incumbent(s) will be required to perform a variety of duties listed, including but not limited to: Provide care coordination services for an assigned caseload to support patients with health care needs through phone consultations, home visits, clinic appointments and/or community contacts.