Utilizing nursing judgment and a proactive, registry-driven approach, this role monitors for changes in members’ clinical and social needs, performs medication reconciliation and clinical triage, and facilitates timely intervention and care coordination across primary care, behavioral health, substance use disorder, pharmacy, dental, and case management services. Apply explicit, criteria-based hand-off triggers: route to Case Manager for LOCUS Level of Care 3+, SMI/SED/I-DD determination, active SUD/MAT treatment, or ACT enrollment; route to Pharmacist for new psychotropic medication or dose change; route to Dental Provider for active dental infection (same-day) or routine referral.