Trainees will have 3 months to build up a minimal panel of 30 and 6 months to work up to a 50 member panel; Sharing and maintaining information with client's multidisciplinary team and implementing activities per CMP, including Community Supports; Support client engagement in support including coordination or medication review and or reconciliation, scheduling appointments, appointment reminders, coordinating transportation, accompany client to critical appointments, identify and address other barriers to client's engagement in services; Ensuring regular contact with the member and their family member(s), guardian, caregiver, and/or authorized support person(s) as part of care coordination; Engage and help client participate in and manage their care; Coaching members to make lifestyle choices based on healthy behavior - goal is for members to successfully monitor and manage their health; Supporting members in strengthening their skills to identify and access resources to assist them in managing and prevention of chronic condition; Linkage to resources based on member's needs such as smoking cessation, self-help recovery, etc. Develop, establish, and maintain professional and collaborative working relationships with internal and external care team; Network with community and stakeholders to remain current on issues and activities as they impact coordination of care for clients; Coordination of care with health plans; Attend required training to maintain provider certification and current industry knowledge; Performs administrative tasks including timely record keeping and data entry; Maintains up to date, adequate records and other documentation necessary for the collection of data and statistics pertaining to program outcomes, demographics, and information as required by funders; Collaborate as an active member of a team; Actively model and communicate the mission and vision and supports a corporate culture of empowerment, team building, and open communication; Maintains compliance with all applicable county, state and federal laws and regulations, funder and program requirements; Performs other duties as assigned.