Description

Member Outreach Specialist

Position Summary

BKG Enterprises is seeking a Member Outreach Specialist to support Medicaid members in accessing healthcare services, benefits, and community resources. This position serves as a direct point of contact for members and conducts proactive outreach to identify barriers to care, provide education, coordinate services, and help members take the necessary steps to address their healthcare needs.

The ideal candidate is personable, persistent, organized, and comfortable helping individuals navigate healthcare and community services.

Hours: Monday - Friday 8am-5pm

Benefits: Health, Dental, Vision

PTO: 80 hours after 90 days

10 paid holidays

Pay: $20-$22/hr

Key Responsibilities

• Conduct inbound and outbound outreach to Medicaid members based on assigned campaigns. 
• Locate and engage members identified by the health plan for outreach. 
• Build rapport with members and caregivers to identify healthcare and social barriers. 
• Educate members regarding available healthcare benefits, services, programs, and incentives. 
• Assist members with scheduling preventive, follow-up, annual wellness, behavioral health, maternal health, and chronic care appointments. 
• Support welcome calls, redetermination outreach, benefits education, and member re-engagement initiatives. 
• Assist members who have had limited healthcare utilization with reconnecting to appropriate care. 
• Help coordinate transportation for healthcare appointments. 
• Connect members with food, housing, transportation, and other community resources. 
• Refer members to care management or care coordination when appropriate. 
• Support health plan quality initiatives and efforts to close gaps in care. 
• Identify urgent or complex member needs and escalate appropriately. 
• Document member contacts, needs, referrals, resolutions, and outcomes within required systems. 
• Follow approved outreach scripts and established policies and procedures. 
• Participate in required training, meetings, and educational activities. 
• Adjust outreach priorities as member and health plan needs change. 

Work Expectations

• Full-time, 40 hours per week. 
• Flexibility to conduct outreach based on member availability, including evening or weekend outreach when necessary. 
• Participation in required company and health plan training. 
• Ability to adapt to changing outreach campaigns and priorities. 
• Timely documentation of member interactions.

Requirements

Qualifications

• Previous experience in healthcare, managed care, Medicaid, customer service, social services, community outreach, or a call center environment preferred. 
• Strong interpersonal and customer service skills. 
• Ability to communicate effectively with individuals from diverse backgrounds. 
• Strong problem-solving skills and ability to identify member needs. 
• Comfortable conducting frequent outbound telephone outreach. 
• Strong organizational and follow-through skills. 
• Ability to manage multiple members and outreach priorities simultaneously. 
• Strong computer and documentation skills. 
• Ability to maintain confidentiality and comply with HIPAA requirements. 
• Knowledge of Indiana Medicaid programs and community resources preferred. 
• Bilingual skills are a plus.