Member Engagement Specialist

Role Overview

• Proactively conduct street-level and site-based outreach across Santa Clara County to identify, engage, and enroll eligible members into ECM and Community Supports programs.
• Build and maintain a consistent presence at community locations including shelters, transitional housing sites, hospitals, emergency departments, behavioral health clinics, food pantries, resource fairs, and encampments.
• Develop and nurture referral relationships with community-based organizations (CBOs), social workers, discharge planners, clinic staff, law enforcement outreach teams, and other partners who can refer members to PHG services.
• Represent Pacific Health Group at community events, health fairs, partner meetings, and coalition gatherings to promote services and expand referral pipelines.
• Distribute PHG outreach and marketing materials to community partners, agencies, and public-facing locations to increase awareness of available services.
• Conduct warm handoffs by introducing prospective members to Lead Care Managers and care teams, supporting a seamless transition from outreach to enrollment.
• Track outreach activities, referral sources, and conversion outcomes to support data-driven outreach strategy and continuous improvement.
• Identify gaps in community awareness of PHG services and recommend targeted outreach strategies to reach underserved populations.
• Conduct initial risk assessments in the field and office settings to understand each member’s health, behavioral health, and social needs.
• Review medical and social histories to determine eligibility for programs such as Enhanced Care Management (ECM) and Community Supports.
• Coordinate with Lead Care Managers and interdisciplinary teams to initiate and support individualized care plans.
• Ensure timely, thorough documentation in PHG systems in accordance with program and compliance requirements.
• Facilitate referrals to internal programs and external providers, ensuring timely access to care and community resources.
• Communicate with clinics, specialists, hospitals, and community-based organizations to support successful member engagement.
• Track referral outcomes and close referral loops, identifying and addressing barriers to access as needed.
• Serve as a point of contact for assigned members via phone, text, and virtual check-ins.
• Conduct follow-up outreach to support continuity of care and ongoing engagement.
• Collaborate with care managers, healthcare providers, and family members to address challenges and support member goals.
• Maintain accurate, timely, and HIPAA-compliant documentation across PHG systems for all outreach contacts, referrals, and member interactions.
• Support quality assurance efforts by auditing data for completeness and participating in continuous quality improvement initiatives.
• Collect and share member feedback to inform service enhancements and outreach workflow improvements.
• Conduct structured re-engagement efforts for inactive members via phone, text, virtual, and in-person outreach.
• Support enrollment, scheduling of assessments, and collection of required documentation.
• Support appropriate dis-enrollment processes in alignment with health plan requirements and documentation standards.

Requirements

• High school diploma or equivalent; associate’s or bachelor’s degree in social work, public health, human services, or related field preferred.
• Minimum 1–2 years of experience in community outreach, street outreach, member engagement, or a related community-facing role within healthcare or social services.
• Demonstrated ability to build relationships and trust with individuals experiencing homelessness, mental health challenges, substance use disorders, and other complex needs.
• Experience working with Medi-Cal populations, managed care, or safety-net healthcare systems preferred.
• Comfort and confidence engaging individuals in non-traditional settings such as encampments, shelters, emergency rooms, and on the street.
• Valid California driver’s license, reliable transportation, and willingness to travel throughout Santa Clara County daily.
• Bilingual in English and Spanish, Vietnamese, or Mandarin strongly preferred.
• Strong interpersonal and rapport-building skills with diverse populations.
• Self-motivated and able to work independently in the field with minimal supervision.
• Excellent organizational skills with the ability to track outreach activities, referrals, and follow-ups.
• Cultural humility and trauma-informed communication approach.
• Proficiency with electronic health records, care management platforms, and basic computer applications.
• Ability to remain calm, compassionate, and professional in challenging or unpredictable community environments.
• Team-oriented with strong collaboration skills across departments and with external partners.

Benefits

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