Member Engagement & Enrollment Specialist

Pacific Health Group; Alexandria (OH); On-site; USD 60,174,000 - 68,770,000; Full time

Benefits offered by this job

401(k) matching

Monthly stipend

Dental insurance

Health insurance

Life insurance

Vision insurance

Paid time off + sick days

Job summary

Pacific Health Group is seeking a Member Engagement Specialist to drive outbound outreach, educate eligible individuals about programs, facilitate enrollments, and assist with Medi-Cal applications when appropriate. You will build rapport, coordinate with Lead Care Managers, and ensure smooth transitions into ongoing care coordination.

The role emphasizes strong communication, compassion, persistence, and organizational skills to improve access to ECM and other PHG services for underserved

Qualifications

• High school diploma or equivalent required.
• Associate's or Bachelor's degree in social work, public health, human services, healthcare administration, or related field preferred.
• Minimum of 1–2 years of experience in customer service, healthcare, member services, outreach, care coordination, or related field.
• Excellent verbal communication and interpersonal skills.
• Comfortable spending the majority of the workday conducting outbound member calls.
• Strong organizational skills and ability to manage multiple priorities.

Responsibilities

• Conduct outbound telephone outreach to prospective members referred by health plans, providers, hospitals, correctional facilities, and community organizations.
• Educate prospective members on Enhanced Care Management (ECM) and other PHG services.
• Build rapport and establish trust with members through compassionate communication.
• Complete member enrollments and obtain required consents and documentation.
• Conduct follow-up outreach to hard-to-reach members and those not yet enrolled.
• Coordinate referrals and warm handoffs to support transitions into ECM services.
• Track referral status from receipt through enrollment and ensure timely follow-up.

Skills

Customer service

Member engagement

Phone etiquette

Active listening

Organization and time management

Problem solving

Documentation

Independent and collaborative work

Education

High school diploma or equivalent

Associate's or Bachelor's degree in social work, public health, human services, healthcare administration, or related field

Job description

Pacific Health Group is seeking a Member Engagement Specialist to drive outbound outreach, educate eligible individuals about programs, facilitate enrollments, and assist with Medi-Cal applications when appropriate. You will build rapport, coordinate with Lead Care Managers, and ensure smooth transitions into ongoing care coordination.

The role emphasizes strong communication, compassion, persistence, and organizational skills to improve access to ECM and other PHG services for underserved