This role synthesizes assessment data, visit documentation, and external care and agency records to establish a member’s current functional level, produces the clinical determination and supporting rationale for initial requests and annual redeterminations, and manages the ongoing clinical exchange with health plan Utilization Management teams. Registered Nurses and Community Health Partners on market care teams, RN Lead, Senior Director of Care Management, Assessment RN and Assessment RN Manager, Advanced Practice Clinicians and Medical Doctors, Behavioral Health team, Pharmacy, Care Team Operations, Quality, Compliance, health plan Utilization Management staff, and external LTSS service agencies.