100% Telehealth Located at Virginia Hospital Center in Arlington, VA and Reston Hospital Center in Reston, VA. For members of a defined population, responsible for collaborating with the members of the health care team to facilitate the coordination of appropriate, cost-effective services that are consistent with member's plan of care, help achieve his/her optimal level of independence, and enhance quality of life. Essential Responsibilities:Responsibilities include, but are not limited to, problem identification, psychosocial assessment, financial counseling/referral, accessing community resources