specialists, respiratory therapist, nutritionist, physical therapist, home health providers, care managers, and social workers) by optimizing the office-based care team to send, receive, and triage information flows among providers. In collaboration with other members of the healthcare team, the RN Care Manager is responsible for organizing, coordinating, and providing care management services, within the practice, who are at risk for health deterioration, poor health outcomes, and/or avoidable utilization of emergency care services.