Member Engagement Specialist

Pacific Health Group

. Conduct outbound telephone outreach to prospective members referred by health plans, providers, hospitals, correctional facilities, community organizations, and other referral sources.

Posted 10/17/2026full-timeRemote • United StatesJunior💰 $46,000 - $52,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in member outreach, enrollment processes, and community resource navigation, with a strong focus on Enhanced Care Management and Medi-Cal applications. Capable of building rapport with diverse populations and maintaining HIPAA-compliant documentation.

Highest-signal resume keywords

Member OutreachEnhanced Care Management (ECM)Medi-Cal ApplicationsCustomer Service ExperienceBilingual Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medi-Cal ApplicationsBenefitsCal ApplicationsCare CoordinationInsurance EnrollmentDocumentation Management

Soft Skills

Excellent Verbal CommunicationInterpersonal SkillsOrganizational SkillsCompassionate CommunicationAbility to Manage Multiple Priorities

Tools & Technologies

Basic Computer ProficiencySoftware Platforms

Industry Keywords

Community Supports (CS)CalAIMHealthcare AdministrationPublic HealthSocial Work

About the role

Key responsibilities & impact

Conduct outbound telephone outreach to prospective members referred by health plans, providers, hospitals, correctional facilities, community organizations, and other referral sources.
Educate prospective members on Enhanced Care Management (ECM) and other available Pacific Health Group services.
Build rapport and establish trust with members through compassionate, professional communication.
Complete member enrollments and obtain required consents and documentation.
Conduct follow-up outreach to members who are difficult to reach or have not yet enrolled.
Coordinate justice-involved member referrals and warm handoffs into ECM services.
Track referral status from receipt through enrollment and ensure timely follow-up.
Assist members with Medi-Cal applications, renewals, BenefitsCal applications, and public benefit navigation.
Educate members on healthcare, behavioral health, and community resources.
Identify and resolve barriers to enrollment or engagement; escalate urgent concerns when appropriate.
Collaborate with Lead Care Managers, health plans, providers, hospitals, correctional facilities, community organizations, and referral partners.
Ensure required documentation is complete before transferring members into active care management.
Maintain accurate, timely, confidential, HIPAA-compliant, and audit-ready documentation.
Represent Pacific Health Group at health fairs, community events, provider meetings, and outreach opportunities.
Promote ECM, Community Supports, and Pacific Health Group services and build referral-partner relationships.

Requirements

What you’ll need

High school diploma or equivalent required.
Associate's or Bachelor's degree in social work, public health, human services, healthcare administration, or a related field preferred.
Minimum of 1–2 years of experience in customer service, healthcare, member services, outreach, care coordination, insurance enrollment, call center operations, or a related field.
Excellent verbal communication and interpersonal skills.
Comfortable spending the majority of the workday conducting outbound member calls.
Strong organizational skills with the ability to manage multiple priorities.
Basic computer proficiency and ability to quickly learn new software platforms.
Valid driver's license and reliable transportation for occasional community events or meetings.
Experience working with Medi-Cal populations preferred.
Knowledge of Enhanced Care Management (ECM), Community Supports (CS), CalAIM, or managed care preferred.
Experience assisting with Medi-Cal or BenefitsCal applications preferred.
Bilingual in English and Spanish, Vietnamese, Mandarin, Russian, or another language commonly spoken within the communities served preferred.
Primarily office and telephone-based work with occasional travel to community events, meetings, and outreach activities.
Ability to occasionally travel throughout assigned service areas for outreach events and meetings.
Ability to lift up to 25 pounds of outreach materials or supplies as needed.

Benefits

Comp & perks

401(k) matching
Monthly Stipend
Dental insurance
Health insurance
Life insurance
Vision insurance
Paid time off + sick days