The RN Case Manager will work in conjunction with Social Workers, Case Managers, Community Health Workers, Physicians, Advanced Practice Providers, community partners and other care team members to provide case management and navigation services, while working in collaboration with inpatient care teams, ambulatory teams, transitions of care teams and other Central Health teams to support patients in the High Risk Population program. Integrates preventive and chronic disease management strategies by addressing remediable barriers to medical independence, facilitating access to preventive screenings and routine care, and building patient skills forsafe and effective self management (e.g., medication organization, monitoring health indicators, safe treatment practices, and use of overdose prevention tools).