Member Engagement Specialist

Member Engagement Specialist

Location: Multi County – Community-Based (California Residents Only))
Employment Type: In-field (70%) / Office (30%)
Compensation: $22.00 to $25.00 per hour
Schedule: Monday through Friday 8:30AM to 5PM
Work Environment: Hybrid, Field-based
Reports To: Member Engagement Manager

About Pacific Health Group

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.

Our Core Values

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

Role Overview & Impact

The Member Engagement Specialist is a high-impact, community-facing role responsible for

driving member growth and engagement across Pacific Health Group’s Enhanced Care

Management (ECM) and Community Supports programs. The majority of this role is spent in

the field—building relationships, generating referrals, and connecting individuals to the

services that can change their lives.This position is the front door to Pacific Health Group for many of our members. The Member

Engagement Specialist actively canvasses community settings—shelters, clinics, hospitals, food

distribution sites, encampments, resource fairs, and partner agency offices—to identify

individuals who qualify for PHG services and support them through enrollment and initial

engagement. This is not a desk job; it is a boots-on-the-ground role that requires initiative,

resilience, and genuine compassion for people navigating complex life circumstances.

In addition to community-based outreach, the Member Engagement Specialist conducts

assessments, facilitates referrals, and ensures accurate, compliant documentation. They serve

as a critical bridge between the community and PHG’s care teams, helping reduce barriers to

care, strengthen continuity of services, and improve health outcomes for Medi-Cal populations

served through Santa Clara Family Health Plan.

What Success Looks Like: A successful Member Engagement Specialist consistently

generates new member referrals through proactive community presence, maintains strong

relationships with partner organizations, and ensures every individual they meet feels

welcomed and supported in connecting to PHG services.

Key Responsibilities

Community-Based Outreach & Referral Generation (Primary Focus – ~50%

of Role)

• 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.

  Member Assessments & Care Coordination (~20% of Role)

• 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.

  Referral Management (~10% of Role)

• 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.

  Virtual & Phone-Based Member Support (~10% of Role)

• 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.

  Quality, Documentation & Re-Engagement (~10% of Role)

• 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 disenrollment processes in alignment with health plan requirements

  and documentation standards.

Requirements

Qualifications

Required

• 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.

  Skills & Competencies

• 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.

  Physical Requirements & Work Environment

• This role requires regular travel throughout Santa Clara County, including driving to

  community sites, walking through various terrain, and spending extended periods

  outdoors in all weather conditions.

• Ability to stand, walk, and move through community settings for extended periods.

• Occasional lifting up to 25 lbs (outreach materials, supplies).

• Flexible schedule may include occasional early mornings, evenings, or weekends to

  align with community events and member availability.

  Pacific