Coordinates and manages patient care by assessing needs, developing care plans, and connecting individuals to appropriate health or social services. Ensures patients receive quality, cost-effective, and holistic support across care settings.Key Responsibilities: Assess Patient Needs: Conduct comprehensive assessments to identify medical, social, emotional, and financial needs. Develop Care Plans: Create individualized care or service plans to promote health outcomes and independence. Coordinate Services: Link patients with healthcare providers, community resources, and support programs. Monitor Progress: Track patient outcomes, adjust care plans as needed, and ensure continuity of care. Advocate for Patients: Represent patient interests to providers, payers, and community resources. Ensure Compliance: Follow state, federal, and organizational regulations in all care activities. Facilitate Transitions: Support smooth transfers between care settings such as hospital, home, or long-term c...