Specific functions within this role include: Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement, Application of process improvement methodologies in evaluating outcomes of care, Coordinating communication with the healthcare team, patients, families and post-acute care services, Readmission screening and prevention. Our approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including: Career growth and development opportunities, with clear pathways and ongoing support.