Manager Care Resume Sample

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Katelin Rowe
707 Howell Motorway,  Dallas, TX
+1 (555) 465 0345

Work Experience


Senior Manager Care Operations
12/2016 - PRESENT
Detroit, MI
  • Experience in call centers; workforce management or process improvement and internal controls required
  • Uses, protects, and discloses patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Consistently exhibits behavior and communication skills that demonstrate Davita, Inc.’s commitment to our mission and values
  • Valid Driver’s license
  • Consistently exhibits behavior and communication skills that demonstrate DaVita Medical Group’s commitment to superior customer service, including quality, care, and concern with internal and external customers
  • Uses, protects, and discloses DaVita Medical Group patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • In conjunction with the PCP, member, member’s family, and other pertinent members of the Interdisciplinary Care Team (IDT), CM completes a comprehensive assessment and develops a Person Centered Service Care Plan utilizing clinical expertise to evaluate the member’s need for alternative services. Assesses short-term and long-term needs and establishes case management objectives
  • Comply with HCAs operating policies and procedures as well as the company’s Zero Tolerance Policy with regard to information safeguards, ethics and harassment
Manager, Care Coordination
06/2011 - 06/2016
Chicago, IL
  • Implements Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the manager’s accountability
  • Functional - Medical Management/Medical Management - Case Management/4+ Years
  • Functional - Clinical / Medical/Direct patient care (hospital, private practice)/4+ Years
  • Functional - Medical Management/Medical Management - Direct patient care/4+ Years
  • Functional - Medical Management/Medical Management - Discharge planning/4+ Years
  • Technical - Desktop Tools/Microsoft Word/4+ Years/End User
  • Technical - Desktop Tools/TE Microsoft Excel/4+ Years/End User
Care Program Manager USD
08/2005 - 03/2011
Dallas, TX
  • Technical - Desktop Tools/Microsoft Outlook/4+ Years/End User
  • Technical - Desktop Tools/Microsoft SharePoint/1+ Years/End User
  • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex clinical indicators which impact care planning and resolution of member issues
  • Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate clinical and service providers for thorough assessment and treatment, as clinically indicated
  • Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services
  • Monitoring, Evaluation and Documentation of Care
  • Two or more years of progressively responsible experience providing care management services

Education


Adams State University
2001 - 2005
Bachelor's Degree in Nursing

Professional Skills


  • Excellent communication skills (written and verbal) as well as strong negotiation skills, judgment and collaborative working approach
  • Excellent PC skills, analytical and problem solving skills needed
  • Strong analytical, presentation and business planning skills coupled with equally strong execution focus
  • Demonstrates a fundamental understanding of basic marketing skills, including 4P’s
  • Exceptional verbal and oral communication skills. Experience in working with teams across locations
  • An excellent communicator and motivator, skilled in managing interpersonal processes and training others
  • Maintain and increase operational skills and knowledge on an on-going basis and attend workshops, seminars, and other training sessions as appropriate

How to write Manager Care Resume

Manager Care role is responsible for medical, health, leadership, crisis, training, analytical, clinical, research, marketing, retail.
To write great resume for manager care job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Manager Care Resume

The section contact information is important in your manager care resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Manager Care Resume

The section work experience is an essential part of your manager care resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous manager care responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular manager care position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions. Representative Manager Care resume experience can include:

  • Demonstrates strong leadership skills and works effectively with other members of the team to achieve individual, team and organizational goals
  • Demonstrates strong clinical, interpersonal, leadership, and team building skills
  • Strong interpersonal communication skills including problem solving, decision making, and crisis intervention are required
  • Strong organizational and written and verbal communication skills are required
  • Establishes and maintains relationships through strong interpersonal skills
  • Solid management skills to supervise the work of the team towards objectives within the area of supervision

Education on a Manager Care Resume

Make sure to make education a priority on your manager care resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your manager care experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Manager Care Resume

When listing skills on your manager care resume, remember always to be honest about your level of ability. Include the Skills section after experience. Present the most important skills in your resume, there's a list of typical manager care skills:

  • Manages resources to effectively deliver powerful digital solutions that transform the patient and consumer digital experience
  • Bilingual English/Spanish speaking skills are highly desired
  • Demonstrated experience in implementing cross company business processes across multiple teams
  • Utilizing evidence-based guidelines, performs assessment of member health needs and develops care plans to address the identified areas
  • Experience managing cross-functional teams, building relationships, and promoting positive change required
  • Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required

List of Typical Experience For a Manager Care Resume

1

Experience For Senior Manager Care Operations Resume

  • Strong knowledge of common medical conditions, symptoms and treatment in addition to community resources, governmental-funded programs, and health plans
  • Strong dedication to customer service and ability to work within a team-focused, participative management framework are required
  • Engaging members into the program by providing compelling rationale on the benefits of the program to fit the unique member’s needs
  • Providing motivational counseling and encourage self-advocacy to help sustain members’ commitment to their care plans and treatment adherence
  • Providing a timely outreach to new referrals
  • Drive regular interface with all functional leaders including training, hiring, operations, analysis and specialized product teams
  • Ensure process excellence by defining, implementing and measuring tasks and action items
  • Provides support with navigating the healthcare system and assists patients with utilizing available community support services
2

Experience For Manager, Care Coordination Resume

  • Manages service assurance technical support operations, driving
  • Employs continuous improvement activities and uses the ACE operating system for maximum benefit
  • Accountable for achieving business goals for a team of up to 25 associates within unit
  • Partner with Work Force Management closely to stay aligned on all staffing requirements
  • Supports an integrated care model tapping into appropriate resources both internally and external to the organization (R)
  • Follow all workflows meeting regulatory and accreditation requirements
  • Case Management certification or ability to become certified within one year of employment. Demonstrated computer competency and ability to type 40-60 words per minute
  • Implements Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the manager’s accountability
  • Implements and continually refines systems and workforce management processes to ensure high quality service delivery. Analyzes technical
3

Experience For Senior Program Manager, Care Continuum Resume

  • In conjunction with management, leading the effort to perform quarterly financial review and analysis (EAC) of CARE/MSP contracts’ performance and annual physical inventory of pooled assets
  • Management responsibilities for assigned customer CARE and/or MSP contracts
  • Provides intelligence to the Customer Support Managers (CSMs) for customers covered under CARE and/or MSP programs
  • Complies with all requirements for EH&S, ITC, Regulatory, and any other UTC absolutes
  • Manage business level metrics (pen rates, occupancy) to high efficiency standards
  • Share in the accountability for a business level function team (Logistics, quality, innovation, morale)
4

Experience For Customer Care Department Manager Resume

  • Execute flawless management of projects assigned to unit
  • Define and measure performance metrics (incentives, monthly scorecards, annual appraisal) and clearly communicate to team
  • Participates in ‘crisis management’ activities, assesses customer impacts, and communication within the call center as it relates to technical issues
  • Drives effective product launches at the call center level through active partnering with Marketing and Field, and assuring that the customer’s voice is represented in the change management process
  • Attends job-related training and informally remains current on competition, technical information regarding Cox’s telephony, data, and video products and offerings, service delivery, leadership skills, etc
  • Demonstrate Leadership Essentials daily
  • Maintaining accurate information in Beacon’s clinical documentation systems as directed
5

Experience For Care Program Manager USD Resume

  • Provides direction to Supervisors whose primary responsibility is to train, coach and develop associates
  • Creates a positive work environment by constant communication with associates
  • Initiate actions to improve performance as needed
  • Conducts weekly and monthly associate / department meetings
  • Fill-in for Director as needed
  • Present and detail ConvaTec products to decision makers and associated staff to help create demand for ConvaTec products, using appropriate selling tools, visual aids and product demonstrations
  • Hospitals, WOCNs, Surgeons, Long Term Care, Long Term Acute Care, Wound Care Clinics
6

Experience For Manager Care Coordination Resume

  • Providing consultation and coordination with the behavioral health or medical providers, facility or, family members, s, community agencies, or involved medical practitioners regarding treatment and/or treatment planning issues
  • Coordinating and consulting with the UM Care Manager and medical care management as necessaryAttending regularly scheduled rounds to consult with a psychiatrist or health plan staff and discuss cases and the need for continued intensive care management and outreach
  • Sending outreach letters to members who are not telephonically accessible or who do not respond to multiple telephonic outreach attempts
  • Providing case closure/discharge at the time of completion
  • Maintain a consistent caseload within parameters as defined by clinical leadership.Communicate as needed with clinical supervisor to address caseload balancing
7

Experience For Manager on Duty, Customer Care Resume

  • Member’s progress and ICM interventions are documented appropriately in the care management system
  • Follows all work flows meetings regulatory and accreditation requirements
  • Facilitate, refer and coordinate appropriate community based services and supports to meet the members’ BH needs
  • Complies with Beacon’s standards for documentation of clinical information, clinical contacts and authorization of care
  • Oversee the Care Coordinator’s (CC) coordination between health care providers and community based services
  • Collaborate with Primary Care Physician (PCP), Behavioral Health Professionals (BHP), and other members of the health care team, including health plan medical care managers and others to arrange and coordinate services for the member and optimize the member’s ability to engage in the appropriate plan of care
  • Growth opportunities involve being a part of LGMC Shared Governance councils
8

Experience For Licensed Clinical Care Manager Resume

  • Ensure workflow alignment with enterprise care coordination and payer’s quality and programmatic agreements
  • 34-bed Progressive Care Unit
  • Types of high acuity patients include: Telemetry, Stroke, Vent, Trach, Percutaneous Coronary Intervention (PCI), and Chediak-Higashi syndrome (CHS)
  • Oversee Individualized Care Plan (ICP) implementation by the Care Coordinator
  • Collaborate with the Care Coordinator updates ICP and provides individual supervision of Care Coordinators
  • Appropriately document clinical information, collateral contact, efforts made to aid members in connecting to care/supports in member’s permanent medical record
  • Manages the tactical execution of the Care Navigation team’s short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing
  • Generate a safe workplace for Associates and contractors via the application of Mars’ Safety Standards, tools and techniques. Lead safety continuous improvement activities, safety drills, and mitigate identified safety risks
9

Experience For Scientific Affairs Manager, M Oral Care Resume

  • Previous experience working with or managing Incident Management including Root Cause Analysis
  • Demonstrated ability to drive operational excellence across continuous improvement, measuring and addressing performance and customer mindset
  • Experience in disease and case management required
  • Demonstrates ability to problem solve and manage change
  • Demonstrates ability to manage complex data sets
10

Experience For Care Manager, Speciality Clinician Resume

  • Clinical practice experience, preferably home health, hospital, ambulatory care, or similar
  • Develop proposals to improve overall efficiency and managed care experience, utilization, quality and clinical outcomes
  • Knowledge of quality and food safety (preferably in food manufacturing)
  • Provides coordination of communications with patients, families, physicians, and healthcare team members
  • Manage all floor operations of the care center and responsible for care center performance as defined

List of Typical Skills For a Manager Care Resume

1

Skills For Senior Manager Care Operations Resume

  • Effective communication skills, especially with medical providers
  • Effective interpersonal communication skills- verbal and written
  • Strong organizational skills with ability to motivate and facilitate activities of multi-disciplinary groups
  • Experienced in psychosocial assessments, knowledge of community resources, and crisis intervention skills
  • Proficient time management & prioritization skills
  • Strong analytical skills; ability to analyze research or performance data, develop insights and apply the insight to optimize product requirements
  • Strong analytical, process, data management and PC skills
  • Strong organizational, time management and quality improvement skills
2

Skills For Manager, Care Coordination Resume

  • Recent experience in care management or 5 years relevant clinical experience
  • Able to continuously challenge the status quo, with a strong desire to improve communication effectiveness
  • Prior experience in care center environments and/or partner management needed
  • Five (5) years of relevant clinical and/or clinical technology experience in a healthcare setting required
  • Experience working with patients with complex mental health and/or substance abuse diagnoses
  • Experience in managing people, accountable for results in a call center financial services/credit card industry
3

Skills For Senior Program Manager, Care Continuum Resume

  • Experience in a home health care setting
  • One (1) year of recent RN experience in an acute care setting within hospital environment
  • Three (3) years of recent RN experience in an acute care setting within hospital environment
  • Three years recent clinical nursing experience in a variety of clinical settings
  • Two years' experience managing care of relevant specialized patient population
  • Recent experience in care management
  • Demonstrate a commitment to patient~focused care
4

Skills For Customer Care Department Manager Resume

  • Identifies and validates new product opportunities
  • Experience in Process Management
  • Three or more years’ medical sales experience required in a highly competitive, aggressive, growth sales environment
  • Work experience in Microsoft Word, Microsoft Excel and Microsoft Outlook
  • Any combination of clinical, case management and/or disease/condition management, provider operations and/or health insurance experience
  • Three (3) years of experience in a leadership role required
  • Excellent interpersonal communication capabilities
  • Sales management of a subscription based business. Experience in customer retention and cross-sell
5

Skills For Care Program Manager USD Resume

  • Three (3) years of Oncology and/or Bone Marrow Transplant Experience
  • Two (2) years of complex case management experience in a managed care environment
  • Expert and proficient knowledge, skill, and ability in MS word, MS Excel, MS PowerPoint, MS Outlook, and MS Project
  • Willing to be accountable for KRAs related to managing LOS, resource utilization (cost), readmissions
  • Using MS Office applications
6

Skills For Manager Care Coordination Resume

  • Working knowledge of care management principles and practices, cost containment principles
  • Willing to travel up to 10% of your time
  • Willing to travel up to 20% of your time
  • Utilization of critical thinking in timely decision-making Current Illinois RN license
  • Familiarity working with vulnerable older adults, with understanding of how to access programs and resources specific to this population
  • Fluency communicating with technical partners such as Engineering on technical product concepts
7

Skills For Manager on Duty, Customer Care Resume

  • BLS if working in a clinical setting
  • Global perspective of changing healthcare environment
  • Leads cross-functional team to develop new product bundles (technology, insights, supply chain, packaging)
  • Collaborates with brand marketing and commercial teams to assist in execution of successful launch
  • Participates in brand planning and overall communication plans
8

Skills For Licensed Clinical Care Manager Resume

  • Develops key briefing documents (e.g. graphics and formula)
  • Comprehensive knowledge of care management, discharge planning, utilization review, value based agreement requirements
  • Embraces changing paradigm for enterprise care management and the need to act in a more coordinated and integrated fashion across the enterprise
  • BS in Nursing or Health Administration required
  • ACLS if supporting a cardiac specialty area i.e., LVAD, TAVR, etc
  • Current IL RN License
9

Skills For Scientific Affairs Manager, M Oral Care Resume

  • Take weekend/holiday call
  • Work in a fast~pased environment with established time constraints and in difficult situations
  • Managed care, government payers, third-party reimbursement
  • InterQual criteria and its application
  • Maps category space, identifies trends and insights and determines opportunities and scope for new ideas
  • Becomes an expert on the oral care category, consumer and shopper
10

Skills For Care Manager, Speciality Clinician Resume

  • Develops concepts and manages new product business analyses
  • Manages business decisions related to new product projects
  • Develops customer presentation materials for new product review meetings
  • Presents new products and activities to Senior Management for review
  • Fosters collaboration between the Office of Digital, facilities, clinics, other Dignity Health entities and external partners
  • Leverages lean, six sigma, and human centered design to ensure processes are efficient and effectively meet the needs of our employees, patients, providers and consumers
  • Ensures the Digital Care Transformation product roadmap is consumer-focused, and is executed on-budget and on-schedule
  • Identifies and evaluates members for enrollment into one of the Memorial Care Medical Foundation Case Management programs through the appropriate mechanisms

List of Typical Responsibilities For a Manager Care Resume

1

Responsibilities For Senior Manager Care Operations Resume

  • Excellent verbal and written communication skills required. (R)
  • Able to effectively manage a team of highly complex members (R)
  • Deep understanding of Marketing, Product Management, Consumer goods market, channels of distribution etc
  • Provides direction and support to staff to assure departmental effectiveness and efficiency
  • Identifies and ensures adherence to evidence-based practice and care management outcomes
  • Experience selling medical products into hospitals/acute care facilities
  • Clean driving record and valid drivers license required
2

Responsibilities For Manager, Care Coordination Resume

  • Serve as key resource to both supervisory staff and external sources on complex issues, departmental direction and future planning
  • Knowledge of leading practice in clinical care and payer requirements
  • Foster a positive & fun culture that is driven by objectives and is customer focused
  • Registered nurse licensed in the state of Maine required
  • Independent travel is required
  • Utilize clinical tools to review member specific health information and conduct comprehensive assessments of referred members’ needs and eligibility
  • Collaborate with member care teams to determine an approach to resolve member issues or meeting needs by evaluating the members benefit plan and available internal and external programs, services, and resources
3

Responsibilities For Senior Program Manager, Care Continuum Resume

  • Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex clinical indicators which impact care planning and resolution of member issues
  • Use advanced clinical skills to perform crisis intervention with members experiencing behavioral health or medical crisis and refer them to the appropriate clinical and service providers for thorough assessment and treatment, as clinically indicated
  • Provide crisis follow up to members to help ensure they are receiving the appropriate treatment and services
  • Enhance medical appropriateness and quality of care
  • Monitor, evaluate, and document care
4

Responsibilities For Customer Care Department Manager Resume

  • Assist in the development of goal-setting and establishing future direction of the operations of a combined case management/utilization management team and assists with operations planning and efficiency
  • Ensure overall compliance with applicable business process requirements, regulatory requirements and accreditation standards that support all lines of business
  • Collaborate with supervisor staff and providers for insights to inform future direction and refinement of overall operations
  • Collaborate with the appropriate cross- functional leadership and external entities to formulate new, innovative ideas to improve departmental performance, reduce costs while enhancing member experience
  • Assesses and evaluates member’s needs of our most complex members, coordinating care utilizing the most appropriate resources to support member needs. Includes member and family as appropriate
  • Engages actively with the member PCP /designee
5

Responsibilities For Care Program Manager USD Resume

  • Engages with the member in support of their treatment team to identify and establish attainable goals that positively impact clinical, financial, and quality of life outcomes for member
  • Acts as the “triage” lead for the care team to identify members with changing conditions in the geo panel supporting navigation to the most appropriate individuals
  • Assesses the needs of members in the geo panel and aligns them with the appropriate member of the care team ( disease manager, behavioral healthcare manger, pharmacist, social worker)
  • Monitors care team performance to insure that members of the geo panel are engaged in a timely fashion and that performance metrics ( Admits/K, ER utilization etc) meet or exceed established thresholds
  • Prior health plan experience highly desirable (P)
  • Clinical experience (R)
  • Provides ongoing monitoring, evaluation, support and guidance to the coordination of the member's health care
  • RN required, current New York State RN license required
  • Computer proficiency required. (R)
6

Responsibilities For Manager Care Coordination Resume

  • Serves as an informal leader of the care team demonstrating excellent team work and collaboration skills. Exhibits informal leadership strengths and team building skills (R)
  • Contributes to the organization’s three indicators of success:Exceptional Clinical Quality, Unparalleled Service, and Consistent Earnings Outperformance
  • RN with current license to practice in the State of Texas
  • Develops and executes strategic business plans, operational goals, and performance metrics that drive dispatch and tech productivity to ensure
  • Coordinating and consulting with the UM Care Manager and medical care management as necessary Attending regularly scheduled rounds to consult with a psychiatrist or health plan staff and discuss cases and the need for continued intensive care management and outreach
7

Responsibilities For Manager on Duty, Customer Care Resume

  • Maintain a consistent caseload within parameters as defined by clinical leadership. Communicate as needed with clinical supervisor to address caseload balancing
  • Send outreach letters to members who are not telephonically accessible or who do not respond to multiple outreach attempts
  • Provide case closure/discharge at the time of completion
  • Responsible for the direct supervision of a team of Care Management/Care Coordination staff
  • Provides delegation oversight as needed and manages vendor relationships as needed
  • Represents Care Management for programs that cross the organization such as the ECF program, Transitions, CCPM, and Care Coordination
8

Responsibilities For Licensed Clinical Care Manager Resume

  • Provides clinical supervision to licensed (LCSW) social workers
  • Identifies staffing needs to support the organization. Develops staffing strategies to ensure appropriate coverage to meet daily and unexpected requirements. Responsible for implementation, monitoring, and adherence of time off policies and procedures
  • Identifies on-going educational needs and opportunities for staff, based on the requirements of the position and specific needs of the individual. Implements targeted staff orientation and training programs
  • Coordinates assessment of appropriate utilization of services, ensuring intervention as needed. Analyzes data, identifies patterns and trends, and ensures information flow to appropriate staff
  • Ensures patient care management plans are developed, implemented, and evaluated in collaboration with attending physician
  • Ensures the development, spread, and maintenance of standardized care management, utilization management, social work, and authorization services workflow and process
  • Works collaboratively with performance improvement leadership to determine and achieve agreed-to performance targets
9

Responsibilities For Scientific Affairs Manager, M Oral Care Resume

  • Identifies and uses available data to monitor and evaluate care management's impact, and to inform and improve staff and system performance
  • Analyzes all available data (e.g., utilization, quality, and claims data) to identify trends such as ALOS (Average Length of Stay), readmissions, and ER (Emergency Room) use; designs, implements, and modifies care management activities accordingly
  • Uses risk-adjusted data to optimize patient management and assignments
  • Assists with the development, management, and forecasting of department budget. Monitors expenses within approved budget. Maintains equipment and services agreements as needed
  • Excellent critical-thinking, problem-solving, and analytical skills
  • Responsible for the implementation of Care Improvement (LEAN) initiatives and principles related to achieving quality and patient satisfaction outcomes
  • Travel throughout the SHCN network for meetings with internal and external stakeholders
  • Strong current working knowledge of care management and utilization management as well as new models of care such as Patient Centered Medical Home (PCMH) and Accountable Care Organization (ACO)
10

Responsibilities For Care Manager, Speciality Clinician Resume

  • Familiarity with the compliance and regulatory standards governing health plans and patient care including NCQA, URAC, federal, state, and other regulatory requirements
  • Perform a diabetes assessment, provide diabetes education and support members with setting behavioral goals
  • Provide care coordination, assess for gaps in care needs such as dilated eye exams, HbA1c and microalbumin ratio’s
  • Support EmblemHealth population health complex care management initiatives by providing care management services engaging with complex individuals enrolled in care management programs
  • Assess plans, implement, coordinate, monitor, and evaluate all options and services with the goal of optimizing the patients’ health status
  • Integrates evidence-based clinical guidelines, preventive guidelines, and protocols, in the development on individualize care plans that are patient-centric, promoting quality and efficiency in the delivery of health care
  • Coordinates care across settings and helps patients/families understand health care options
  • Assess and evaluate needs of our complex members, coordinating care utilizing the most appropriate resources to support member needs. This includes member and family as appropriate
  • Engage actively with the member PCP /designee

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