Outreach Team Member - Enhanced Care Management (California Residents Only) at Pacific Health Group

Location: Fully Remote – Must be in California 
Employment Type: Full-Time
Hourly Pay Range: $24 – $27 per hour

About Pacific Health Group

At Pacific Health Group, we are at the forefront of revolutionizing healthcare. You will play a vital role in this mission. We are dedicated to improving health outcomes by addressing social determinants of health and coordinating comprehensive community-based services, particularly through our programs. If you are passionate about making a difference and have the skills to lead in this dynamic environment, we invite you to join our team.

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. 
 

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

Time Off & Leave

• 160 Hours of Paid Time Off (PTO)
• 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment
• 4 Paid Volunteer Hours per Month to support causes you care about
• Bereavement Leave, including Fur Baby Bereavement

Health & Wellness

• 90% Employer-paid Employee-Only Medical Benefits
• Flexible Spending Account (FSA)
• Short-Term & Long-Term Disability | AD&D
• Employee Assistance Program (EAP)

Financial & Professional

• Competitive hourly pay ($24–$27) with uncapped commissions and performance-based bonuses
• 401(k) with Company Match
• Monthly Stipend
• Opportunities for professional development and internal growth
• Training stipends, mentorship programs, and promotion tracks. 

Culture & Perks

• Employee Discounts via Great Work Perks and Perks at Work
• Quarterly In-Person Events
• Remote-first work with optional field collaboration; flexible scheduling available. 

Equal Opportunity Employer
Pacific Health Group is an Equal Opportunity Employer. We are committed to creating an inclusive and equitable workplace where all individuals are treated with dignity and respect. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender, gender identity or gender expression, sexual orientation, national origin or ancestry, citizenship status, physical or mental disability, medical condition (including cancer and genetic characteristics), age (40 and over), marital status, military or veteran status, genetic information, or status as a victim of domestic violence, assault, or stalking. We value diversity in all forms and encourage individuals from historically underrepresented communities to apply.

Job Application & Offer Disclaimer

Pacific Health Group is committed to maintaining a transparent, lawful, and secure hiring process in compliance with California labor laws and employment standards. No candidate will be offered employment without meeting the required qualifications and skillset for the position and successfully completing all steps of our recruitment process, which include:

• Submission of a completed internal application via our HRIS system
• A formal pre-screen with our recruiting team
• Completion of a skills assessment (if applicable to the position)
• Participation in a final interview with hiring leadership
• Receipt of a formal verbal offer from our authorized hiring team

AI & Human Interaction (HI) in Recruitment

Pacific Health Group is committed to fairness, equity, and transparency in our hiring practices. We use AI (Artificial Intelligence) tools to help match candidate resumes against our job descriptions, focusing on qualifications, skillsets, and location.

All resumes that meet these criteria are then reviewed by HI (Human Interaction) — our recruiting and HR team. Pacific Health Group remains true to our Equal Employment Opportunity (EEO) statement, ensuring that every candidate is given fair and consistent consideration.