Tuality Health Alliance manages an Oregon Health Plan for members in Hillsboro and Western Washington County Oregon. The Nurse Case Manager performs advanced case management and intervention for high risk members of the Tuality Health Alliance by using a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services to meet an individual's health needs using communication and available resources to promote quality and, cost effective outcomes. Provides support for primary care practices to function as patient-centered medical homes through direct member support, process improvement, and provision of linkage to community resources. Analyzes patient medical records concurrently and/or retrospectively for utilization review, quality assessment, risk management and discharge planning criteria. Provides leadership for the development and implementation of quality improvement activities. Provides back-up for Utilization Review Nurse as necessary.