CalAIM Intake & Referral Specialist – Member Services

Whole Person Care Clinic; Santa Ana (CA); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Paid time off

Vision insurance

Job summary

NHHA is seeking a CalAIM Intake & Referral Specialist to manage intake calls, process referrals, and connect members to appropriate services. You will coordinate with nonprofit partners and document interactions in our EHR systems.

Ideal candidates bring 1–3 years of customer service or call center experience, strong communication, and the ability to multitask while maintaining confidentiality and accuracy.

Qualifications

• 1–3 years in customer service, call center operations, healthcare, or social services preferred.
• Familiarity with Medi-Cal, CalAIM, or community-based programs a plus.
• Strong customer service and telephone skills; effective communication.

Responsibilities

• Receive and respond to calls and messages from members seeking assistance.
• Conduct member intake by gathering relevant information and verifying eligibility.
• Triage and process referrals, connecting clients to services promptly.
• Maintain accurate documentation of member information, referral status, and outcomes.
• Follow up on referrals to ensure successful closure.
• Provide professional, compassionate, and culturally sensitive support to members.

Skills

Customer service

Telephone skills

Communication

Multitasking

Documentation

EHR systems

CRM platforms

Tools

Call center software

CRM platforms

Database systems

Job description

OVERVIEW

NHHA is committed to employee well-being and work-life balance. This role supports the day-to-day operations of our call center, assisting members and community clients with intake, referrals, and connections to healthcare and social services. Duties may evolve to meet NHHA’s needs, but the primary purpose of this position is to provide compassionate, accurate, and timely support to members while ensuring smooth referral processes.

JOB SUMMARY

We are seeking a detail-oriented, empathetic, and proactive CalAIM Intake & Referral Specialist to manage intake calls, process referrals, and connect members to appropriate services. This role focuses on frontline support, accurate documentation, and effective coordination with nonprofit and community partners.

KEY RESPONSIBILITIES

Intake & Referral Management

• Receive and respond to incoming calls and messages from members seeking assistance.
• Conduct member intake by gathering relevant information and verifying eligibility.
• Triage and process referrals, ensuring clients are connected to the right services promptly.
• Maintain accurate and timely documentation of member information, referral status, and outcomes using NHHA database and EHR systems.
• Follow up on referrals to ensure successful closure.

Member Support & Customer Service

• Provide professional, compassionate, and culturally sensitive support to members.
• Address member questions or concerns and provide guidance on available services.
• Collaborate with internal teams and nonprofit partners to ensure member needs are met.

Outreach & Engagement

• Assist with outreach to members listed on health plan Member Information Files (MIFs) to engage them in Enhanced Care Management (ECM) or other programs.
• Conduct outreach via phone, community engagement, or other channels as appropriate.

Resource Coordination

• Maintain knowledge of local healthcare, social, and community resources.
• Assist in updating and managing internal resource directories for efficient referral navigation.
• Connect members with appropriate services based on their needs and eligibility.

Quality & Compliance

• Follow NHHA policies, procedures, and regulatory requirements.
• Maintain strict confidentiality of all member and organizational information.
• Participate in training sessions to ensure adherence to best practices and program standards.

POSITION REQUIREMENTS & QUALIFICATIONS

Experience

• 1–3 years in customer service, call center operations, healthcare, or social services preferred.
• Familiarity with Medi-Cal, CalAIM, or community-based programs a plus.

Skills

• Strong customer service and telephone skills.
• Excellent communication and interpersonal abilities.
• Ability to multitask, prioritize, and handle sensitive situations professionally.
• Proficiency in database and EHR systems for documentation and referral tracking.
• Basic computer skills; familiarity with call center software or CRM platforms preferred.
• Strong problem-solving skills and ability to work independently.

General Expectations

• Demonstrate professionalism, punctuality, and commitment to NHHA’s mission.
• Maintain confidentiality of member and organizational information.
• Perform duties accurately, efficiently, and with attention to detail.
• Collaborate effectively with colleagues, internal teams, and nonprofit partners.

NHHA is an equal opportunity employer and welcomes candidates from diverse backgrounds. We offer competitive pay, professional development opportunities, and a supportive work environment.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance