Communicates and coordinates with providers or Care Team regarding hospital discharge, Emergency Department visits, consulting physicians, community resources, disease management, patient self-management, patient and/or family education on chronic conditions, and labs or other testing as well as specialist visits. Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.