Outreach Engagement and Retention Specialist

Northeast-Community-Clinic-4; Alhambra (CA); On-site; USD 52,000 - 76,000; Full time

Job summary

Northeast-Community-Clinic-4 in California seeks an Outreach Engagement and Retention Specialist to identify, engage, and enroll eligible members into the Enhanced Care Management program at the primary access point of care.

The role serves as a liaison between members, care teams, and health plans, coordinating services and ensuring timely outreach across multiple channels. Onsite schedule Monday–Friday 8:00 a.m.–5:00 p.m. with flexibility for evenings/weekends as needed.

Qualifications

• High School Diploma or GED required.
• Associate’s degree or higher preferred.
• At least 1 year of customer service, call center, or patient-facing experience.
• Experience in a Federally Qualified Health Center (FQHC) or community health setting preferred.
• Bilingual English/Spanish required.
• Strong organizational skills and attention to detail.
• Valid CA Driver's License and Proof of Insurance.
• Knowledge of Medi-Cal managed care system preferred.

Responsibilities

• Identify, engage, and enroll eligible ECM program members.
• Serve as liaison between members, care teams, and health plans.
• Document outreach attempts and outcomes in tracking systems per policies.
• Verify Medi-Cal eligibility prior to enrollment activities.
• Submit referrals to health plans and monitor closure to final disposition.
• Maintain confidentiality of patient information per HIPAA.

Skills

MS Office

Communication skills

Customer service

Bilingual English/Spanish

Team player

Independent work

Multitasking

Education

High School Diploma or GED

Associate degree or higher preferred

Job description

Position Summary:The Outreach Engagement and Retention Specialist is responsible for identifying, engaging, and enrolling eligible members into the Enhanced Care Management (ECM) program. This role serves as primary outreach and engagement specialist and is a key liaison between members, care teams, and health plans, ensuring members receive coordinated, comprehensive care services that address medical, behavioral, and social needs. The ECM Enroller operates with a high degree of independence and initiative, driving outreach effectiveness and program compliance through ownership of workflows, systems, and member relationships at the primary access point of care.Schedule:Onsite presence – Monday through Friday 8:00 a.m. – 5:00 p.m.Flexible, including evenings and weekends based on operational needs.Hours worked per week may exceed 40 hoursDuties and ResponsibilitiesEnsure the highest capture rate of engagement and retention of ECM membership from NECC’s internal active patients who qualify for the ECM program.Ensure the highest rate of Capture and Engagement of External members identified through external referral lists, including health plans, community partners, homeless shelters, and other referral sources.Ensure the highest rate of Re-Engagement / Membership Disposition Status of ECM members when they are lost to communication.Ensure a high level of engagement and participation of eligible members into the ECM program.Ensure all potentially eligible ECM members identified through internal and external sources are engaged into care, with urgency and consistency.Explain ECM program services, benefits, eligibility requirements, and member rights in a clear and understandable manner.Complete outreach attempts daily across multiple communication channels. (i.e. telephone, SMS, and written correspondence) tailored to the individual member’s needs and circumstances.Ensure accurate and timely documentation of all outreach attempts, methods used, outcomes and coordination activities, in applicable tracking systems per DHCS, contracted health plans, and NECC internal standards, ensuring no member falls through the gap due to missed contact cycles.Proactively problem-solve barriers to contacting members and escalate unresolved cases appropriately to care team/management.Verify Medi-Cal eligibility for each member using health plan provider portals prior to enrollment activities.Submit internal and external referrals to the contracted health plans and monitor submission to close referral loop.Build rapport and establish trust with members and their families. Reengaging members who have disengaged from ECM services or declined ECM services through targeted outreach initiatives.Ensure full-cycle engagement and enrollment for each potential member is executed thoroughly and timelyEnsure facilitation of warm hand-off transition of member to assigned LCM for ongoing engagement and program engagement.Identify and address eligibility issues to prevent gaps in coverage and care.Ensure daily membership outreach activity and outcome is documented, tracked, and submitted to ECM Management.Maintain confidentiality of all patient and member information in compliance with HIPAA and NECC policies and procedures.Other duties as designated by ECM Management.Minimum RequirementsProficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint)Excellent Communication SkillsExcellent Customer Service (Bedside Manners)Bilingual English/Spanish requiredAbility to work as a team player and work independentlyAbility to work with complex and multi-faceted tasks and systemsRequired Education/Experience and/or Licensure/CertificationsHigh School Diploma or GED required.Associate’s degree or higher preferred.Minimum one (1) year of experience in a customer service, call center, or patient-facing role.Experience in a Federally Qualified Health Center (FQHC) or community health setting preferredExperience working in outreach and customer service within the medical office and behavioral health environments with individuals who struggle with chronic illness, substance use disorders and mental health issues is preferred.Familiarity with Medi-Cal managed care system and eligibility requirements preferredStrong organizational skills and attention to details to perform tasks accurately and efficiently.Valid CA Driver’s License and Proof of InsuranceWorking ConditionsOSHA Category 3 Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment.The work is majority of the time sedentary in nature.The employee is regularly required to communicate, frequently required to use repetitive motions, move, remain stationary, regularly push, pull and lift up to 20 pounds and occasionally push, pull and lift up to 40 pounds.Must possess mobility to work in a standard office/clinic setting (in some cases both settings) and to use standardoffice/clinic equipment, including a computer, stamina to maintain attention to detail despite interruptions, read printedmaterials and use a computer, and communicate in person and over the telephone.