Member Engagement Specialist

This is a fully remote position, open to applicants in Kansas, +3 more states.

📋 Description

• Perform outbound calls to potential members referred by health plans, providers, hospitals, correctional facilities, community organizations, and other sources.

• Inform potential members about Enhanced Care Management (ECM) and other services provided by Pacific Health Group.

• Develop rapport and trust with members through empathetic and professional communication.

• Complete member enrollments and secure necessary consents and documentation.

• Conduct follow-up outreach to members who are challenging to reach or who have not yet completed enrollment.

• Facilitate referrals for justice-involved members and provide warm handoffs into ECM services.

• Monitor referral status from receipt to enrollment, ensuring timely follow-ups.

• Assist members with Medi-Cal applications, renewals, BenefitsCal applications, and public benefits navigation.

• Educate members about healthcare, behavioral health, and community resources.

• Identify and address barriers to enrollment or engagement and escalate urgent issues when necessary.

• Collaborate with Lead Care Managers, health plans, providers, hospitals, correctional facilities, community organizations, and referral partners.

• Ensure that all required documentation is complete prior to transferring members into active care management.

• Maintain accurate, timely, confidential, HIPAA-compliant, and audit-ready records.

• Represent Pacific Health Group at health fairs, community events, provider meetings, and outreach initiatives.

• Promote ECM, Community Supports, and Pacific Health Group services while building relationships with referral partners.

⛳️ Requirements

• High school diploma or equivalent is required.

• An Associate's or Bachelor's degree in social work, public health, human services, healthcare administration, or a related field is preferred.

• A minimum of 1–2 years of experience in customer service, healthcare, member services, outreach, care coordination, insurance enrollment, call center operations, or a similar field.

• Exceptional verbal communication and interpersonal skills.

• Comfortable spending most of the workday making outbound calls to members.

• Strong organizational abilities with the capacity to manage multiple priorities effectively.

• Basic computer skills and a quick aptitude for learning new software platforms.

• A valid driver's license and dependable transportation for attending occasional community events or meetings.

• Experience with Medi-Cal populations is preferred.

• Familiarity with Enhanced Care Management (ECM), Community Supports (CS), CalAIM, or managed care is preferred.

• Experience assisting individuals with Medi-Cal or BenefitsCal applications is preferred.

• Bilingual proficiency in English and Spanish, Vietnamese, Mandarin, Russian, or another language commonly spoken in the communities served is preferred.

• Primarily office and telephone-based work with occasional travel to community events, meetings, and outreach activities.

• Ability to travel occasionally within assigned service areas for outreach events and meetings.

• Capability to lift up to 25 pounds of outreach materials or supplies as needed.

🏝️ Benefits

• 401(k) matching

• Monthly stipend

• Dental insurance

• Health insurance

• Life insurance

• Vision insurance

• Paid time off + sick days