Pride Health
Base pay range
$40.00/hr - $42.00/hr
Job Title Outreach Specialist – Quality & Member Engagement
Job Summary The Outreach Specialist supports Quality Management and Care Coordination initiatives by engaging members through outreach efforts, administering Health Risk Assessments (HRA), identifying care needs, and connecting members to appropriate clinical and social services. This role plays a critical part in improving member outcomes, quality performance, and overall satisfaction through effective communication, accurate documentation, and coordinated follow-up.
Key Responsibilities
Conduct outbound and inbound outreach to members to administer Health Risk Assessments (HRA) and gather relevant health information
Identify member needs and coordinate appropriate referrals to clinical, behavioral health, and social support services
Support care coordination activities, including scheduling appointments, transportation, and follow-up services
Document all member interactions accurately and in a timely manner in electronic systems in compliance with regulatory and quality standards
Enter, track, and maintain medical and outreach data; assist with reporting and quality metrics
Provide members with basic benefit education and navigation support
Collaborate with Care Management, Quality Management, and internal departments to ensure continuity of care
Escalate clinical concerns or high-risk cases to appropriate clinical staff or leadership
Participate in team meetings, trainings, and quality improvement initiatives
Represent the organization professionally during outreach events and member interactions
Perform additional duties as assigned
Required Qualifications
High school diploma or GED required
Minimum of one (1) year of experience in healthcare, managed care, care coordination, or member outreach
Experience working directly with patients or health plan members
Strong customer service and communication skills
Ability to accurately document and manage data across multiple systems
Proficiency with Microsoft Word, Excel, and Outlook
Ability to manage multiple priorities in a fast-paced environment
Preferred Qualifications
Managed care experience (Medicaid, Medicare, or health plan environment)
Experience administering Health Risk Assessments (HRA)
Background as a Medical Assistant, LVN/LPN, or similar clinical support role
Bachelor’s degree in healthcare, public health, social work, or related field
Bilingual proficiency (Spanish, Haitian Creole, Russian, or other languages)
Member-focused and service-oriented mindset
Strong interpersonal and problem-solving skills
Attention to detail and organizational excellence
Professional, nonjudgmental, and culturally sensitive approach
Ability to work independently and collaboratively
High level of integrity and confidentiality
Full-time, 40 hours per week
Field-based and/or office-based outreach, depending on business needs
May include community outreach events and member-facing activities
Why Join Us
Opportunity to make a meaningful impact on member health outcomes
Collaborative and mission-driven healthcare environment
Exposure to quality management and population health initiatives
Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Seniority level:
Associate
Employment type:
Contract
Job function:
Administrative, Customer Service, and Public Relations
Industries:
Hospitals and Health Care
Location:
New York, NY
#J-18808-Ljbffr
Job Title Outreach Specialist – Quality & Member Engagement
Job Summary The Outreach Specialist supports Quality Management and Care Coordination initiatives by engaging members through outreach efforts, administering Health Risk Assessments (HRA), identifying care needs, and connecting members to appropriate clinical and social services. This role plays a critical part in improving member outcomes, quality performance, and overall satisfaction through effective communication, accurate documentation, and coordinated follow-up.
Key Responsibilities
Conduct outbound and inbound outreach to members to administer Health Risk Assessments (HRA) and gather relevant health information
Identify member needs and coordinate appropriate referrals to clinical, behavioral health, and social support services
Support care coordination activities, including scheduling appointments, transportation, and follow-up services
Document all member interactions accurately and in a timely manner in electronic systems in compliance with regulatory and quality standards
Enter, track, and maintain medical and outreach data; assist with reporting and quality metrics
Provide members with basic benefit education and navigation support
Collaborate with Care Management, Quality Management, and internal departments to ensure continuity of care
Escalate clinical concerns or high-risk cases to appropriate clinical staff or leadership
Participate in team meetings, trainings, and quality improvement initiatives
Represent the organization professionally during outreach events and member interactions
Perform additional duties as assigned
Required Qualifications
High school diploma or GED required
Minimum of one (1) year of experience in healthcare, managed care, care coordination, or member outreach
Experience working directly with patients or health plan members
Strong customer service and communication skills
Ability to accurately document and manage data across multiple systems
Proficiency with Microsoft Word, Excel, and Outlook
Ability to manage multiple priorities in a fast-paced environment
Preferred Qualifications
Managed care experience (Medicaid, Medicare, or health plan environment)
Experience administering Health Risk Assessments (HRA)
Background as a Medical Assistant, LVN/LPN, or similar clinical support role
Bachelor’s degree in healthcare, public health, social work, or related field
Bilingual proficiency (Spanish, Haitian Creole, Russian, or other languages)
Member-focused and service-oriented mindset
Strong interpersonal and problem-solving skills
Attention to detail and organizational excellence
Professional, nonjudgmental, and culturally sensitive approach
Ability to work independently and collaboratively
High level of integrity and confidentiality
Full-time, 40 hours per week
Field-based and/or office-based outreach, depending on business needs
May include community outreach events and member-facing activities
Why Join Us
Opportunity to make a meaningful impact on member health outcomes
Collaborative and mission-driven healthcare environment
Exposure to quality management and population health initiatives
Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Seniority level:
Associate
Employment type:
Contract
Job function:
Administrative, Customer Service, and Public Relations
Industries:
Hospitals and Health Care
Location:
New York, NY
#J-18808-Ljbffr