Member Engagement Specialist

At Pacific Health Group, we care deeply about the people and communities we serve. We meet individuals with kindness, respect, and understanding—listening first, honoring each person's journey, and offering support without judgment. Through compassionate, person-centered healthcare, behavioral health services, and social supports, we walk alongside people as they work toward healing, stability, and a healthier, more hopeful life.

• Speak with integrity—clear, respectful, and honest in every interaction.
• Embrace innovation by trying new ideas, learning quickly, and continuously improving care.
• Own our roles by staying accountable for outcomes and documenting accurately.
• Build genuine connections with members, families, teammates, and community partners through empathy and cultural sensitivity.
• Lead with trust by being consistent, transparent, and following through.
• Celebrate wins together by recognizing both individual and team achievements.
• Collaborate with purpose across departments, health plans, providers, and community organizations.
• Ask for support and offer support because thriving together is how we best serve our members.

• The Member Engagement Specialist serves as the first point of contact for prospective Pacific Health Group members. This role is responsible for conducting outbound outreach, educating eligible individuals about the various programs offered through Pacific Health Group, facilitating enrollments, assisting with Medi-Cal applications when appropriate, and ensuring a seamless transition into services.The primary responsibility of this position is conducting outbound phone outreach to members referred by health plans, providers, hospitals, correctional facilities, and community organizations. Member Engagement Specialists build rapport, educate members on available services, assist with enrollment, coordinate justice-involved and community-based warm handoffs, and ensure members are successfully connected with Lead Care Managers for ongoing care coordination.
• This role also supports Medi-Cal and BenefitsCal applications, maintains strong relationships with referral sources, and represents Pacific Health Group at community outreach events to promote awareness of available services.Success in this position requires exceptional communication skills, compassion, persistence, strong organizational abilities, and a genuine passion for improving access to care for underserved populations.

• The Member Engagement Specialist plays a vital role in connecting vulnerable individuals with healthcare and social services that can improve their quality of life. As the first interaction many members have with Pacific Health Group, this role sets the tone for the member experience by creating trust, reducing barriers to care, and ensuring eligible individuals receive timely access to ECM, CS, and other services.

• Primarily office and telephone-based work with occasional travel to community events, meetings, and outreach activities.
• Frequent sitting, typing, and telephone communication throughout the workday.
• 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.

• 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 California driver's license and reliable transportation for occasional community events or meetings.

• Experience working with Medi-Cal populations.
• Knowledge of Enhanced Care Management (ECM), Community Supports (CS), CalAIM, or managed care.
• Experience assisting with Medi-Cal or BenefitsCal applications.
• Bilingual in English and Spanish, Vietnamese, Mandarin, Russian, or another language commonly spoken within the communities served.

• Exceptional customer service and member engagement
• Strong verbal communication and phone etiquette
• Active listening and rapport-building
• Compassion and empathy
• Professionalism and cultural sensitivity
• Organization and time management
• Problem-solving and critical thinking
• Accurate documentation
• Ability to work independently and collaboratively
• Adaptability in a fast-paced environment
• Basic computer proficiency and ability to learn multiple software systems