Overview
As an Outreach Team Member at Pacific Health Group, you will be the first point of contact for individuals who qualify for Enhanced Care Management (ECM). This role goes beyond outreach—it’s about building trust, breaking down barriers, and ensuring that underserved community members receive access to healthcare resources that improve quality of life. You will combine sales acumen, empathy, and healthcare knowledge to connect people with services they might otherwise miss. This position is ideal for someone who thrives in mission-driven work, is resilient in the face of rejection, and can turn complex healthcare systems into clear, accessible benefits for individuals and families.
Responsibilities
1. Outreach & Engagement
- Initiate contact through multiple channels: phone, SMS, email, live chat, social media, and in-person outreach (in coordination with field teams).
- Leverage data-driven lead lists to prioritize high-need individuals while ensuring a personal, human-centered approach.
- Develop tailored messaging strategies based on the prospect’s health conditions, demographics, and communication preferences.
- Contact a list of leads assigned to your account for campaign fulfillment and outreach efforts for member enrollment.
2. Program Enrollment & Education
- Deliver clear, compassionate explanations of ECM benefits (e.g., reduced ER visits, free transportation, medication coordination).
- Conduct eligibility screenings and complete initial assessments with accuracy and efficiency.
- Guide participants through a seamless onboarding process, ensuring expectations are set early.
- Set clear and concise expectations for each journey perspective of care in parts of the transitional period for enrollment.
3. Relationship Building
- Establish rapport using motivational interviewing and trauma-informed care principles.
- Practice cultural humility, ensuring communication is sensitive to diverse backgrounds, health literacy levels, and personal experiences.
- Serve as a trusted advocate, identifying additional needs (e.g., food insecurity, housing instability, behavioral health support) and escalating to care coordinators when appropriate.
4. Collaboration & Teamwork
- Partner with evening and weekend outreach teams for round-the-clock coverage.
- Share insights from conversations to improve marketing campaigns and referral pipelines.
- Support cross-department initiatives (e.g., Street Outreach, Provider Relations, marketing, and Case Management).
5. Reporting & Accountability
- Document every interaction in designated platforms (SalesMate, Monday.com, TheraPlatform, etc.) with high attention to accuracy.
- Provide weekly summaries of performance, challenges, and success stories to supervisors.
- Track personal metrics and actively participate in performance review cycles.
Qualifications
Core Skills:
- Strong communication skills (verbal, written, digital).
- Resilient, goal-oriented mindset with the ability to handle rejection.
- Ability to adapt tone and approach for different populations (e.g., seniors, caregivers, nonEnglish speakers)
Technical Skills:
- Comfortable using CRMs, HIPAA-compliant chat platforms, and telehealth tools.
- Ability to work with spreadsheets and reporting dashboards.
Experiential Skills:
- For patient engagement, at least 3-5 years in sales, outreach, and cold calling (or 2-3 years in a healthcare setting).
- Demonstrated success in meeting enrollment, sales, and goal targets.
Preferred:
- Knowledge of Medi-Cal/Medicare systems
- Multilingual fluency.
- Experience working with underserved or high-need populations.
Success Measures Quantitative Metrics
• Enrollment: 12+ new participants per week.
• Conversion Rate: 72% from first contact to enrollment.
• Engagement Rate: 100% in completion of outreach activities
• Follow-Up Compliance: 100% of participants contacted within 30 days of enrollment.
• Documentation Accuracy: 92%+ compliance across platforms.
Qualitative Metrics
• Positive member testimonials and satisfaction survey scores.
• Demonstrated empathy and consistency in handling objections.
• Effective collaboration with care teams, reflected in internal peer reviews.
Example Scenarios Scenario
Scenario 1: Cold Calling a High-Need Member You receive a list of Medicaid members who qualify for Enhanced Care Management based on chronic conditions. You call Mr. Johnson, who has diabetes and heart failure. He’s hesitant because he “doesn’t want more doctor appointments.” You explain that ECM actually coordinates his existing appointments and provides free transportation. You share how another participant with similar conditions reduced ER visits by 70% through the program. After reassurance, Mr. Johnson agrees to an initial assessment.
Scenario 2: Coordinating Services for a Family You are assigned a patient list from our healthcare provider network. One member, Ms. Rivera, initially insists that her son’s guardian is managing care. While speaking with her, you identify that her son has speech therapy needs that are not being met. You educate her on how ECM can fill the gap by connecting with a local therapist at no extra cost. By showing empathy and identifying an unmet need, you secure her agreement to enroll her son.
Scenario 3: Following Up on a Provider Referral Dr. Smith refers Ms. Williams, a patient with multiple chronic conditions who frequently misses appointments. During your call, Ms. Williams voiced frustration with managing her medications and transportation. You highlight how ECM provides a dedicated care coordinator who simplifies her care, arranges rides, and connects her to food programs. Initially resistant, Ms. Williams changes her mind when you emphasize that the program is free, and agrees to an intake assessment.
Scenario 4: Digital Outreach via Chat & SMS A patient uses the “Need Help?” widget on our website. Ms. Garcia asks about transportation services but is nervous about sharing personal data online. You reassure her about HIPAA protections and offer to shift the conversation to SMS. Over text, you confirm her eligibility, send a secure intake link, and schedule her video call. By day’s end, Ms. Garcia is successfully enrolled—all without a phone call.
Scenario 5: Handling a Decline with Persistence & Retargeting You reach out to Mr. Lee, who qualifies for ECM due to COPD and mobility challenges. He declines, saying he “doesn’t want another program calling.” Instead of pushing, you validate his frustration and log the interaction. Two weeks later, during your scheduled retargeting follow-up, you call again and share a success story about another member who avoided hospitalization after joining ECM. This time, Mr. Lee expresses curiosity. By the end of the call, he agrees to a free assessment—showing how persistence and empathy can convert an initial “no” into a positive outcome.
Training & Development
Pacific Health Group invests in continuous professional growth. Outreach Team Members will receive:
- Onboarding Academy: Training in system, software, structure, HIPAA compliance course, motivational interviewing, cultural competence, and ECM program specifics.
- Ongoing Coaching: Bi-weekly coaching sessions with team leads to refine scripts, objection handling, and digital tools usage.
- Career Pathways: Clear advancement opportunities into Senior Outreach Specialist, Outreach Lead, Outreach Supervisor, Care Coordinator roles, other.
Culture & Mission Alignment
We are looking for team members who embody Pacific Health Group’s core values:
- Compassion: Every interaction prioritizes dignity and respect.
- Persistence: Outreach requires resilience—success often comes after multiple attempts.
- Accountability: Data integrity and follow-up directly impact patient outcomes.
- Collaboration: Success is shared; team wins matter as much as individual performance.
- Innovation: Outreach is not static—team members are encouraged to propose new methods and tools for engagement.
Benefits & Perks
• Financial: Competitive hourly pay ($24–$27) with uncapped commissions and performance-based bonuses.
• Wellness: Comprehensive medical, dental, vision, life, and EAP coverage.
• Flexibility: Remote-first work with optional field collaboration; flexible scheduling available.
• Career Growth: Training stipends, mentorship programs, and promotion tracks.
• Community Impact: Direct contribution to reducing ER visits, improving chronic disease outcomes, and addressing social determinants of health.
• Office Location: Remote-based, work from home.
