Care Navigator – Outbound Member Engagement
Position Overview :
This is a high-volume outbound call role , focused on connecting with members to discuss their benefits, complete health and lifestyle assessments, and guide them through available support programs. The Care Navigator plays a key role in helping members understand and access enhanced services under the 1115 Waiver and other community-based resources.
Key Responsibilities :
- Conduct outbound calls to members to initiate conversations about benefits and perform initial health and living situation assessments.
- Explain available programs and services, ensuring members understand their eligibility under the 1115 Waiver.
- Assess members’ eligibility for enhanced Health-Related Social Needs (HRSN) services and connect them with appropriate local, state, or federal resources.
- For members not yet engaged, perform outreach and document all contact attempts according to established timelines and communication protocols.
- Obtain and record member consent and attestation during the engagement process.
- Utilize screening tools to identify needs such as housing, food access, or transportation.
- Communicate regularly with internal teams, community partners, and service providers to ensure referrals are accepted, completed, or redirected as necessary.
- Accurately document all outreach activities, referrals, and progress notes in accordance with program quality standards.
- Collaborate closely with supervisors and team members to achieve outreach and engagement goals.
Required Skills & Qualifications :
Strong communication and customer service abilities; skilled at building rapport and trust over the phone.Previous experience with Medicaid populations or public health programs preferred.Bilingual in Spanish and English highly preferred.Highly organized, detail-oriented, and capable of meeting goals in a fast-paced, mission-driven environment.Must be proactive, confident, and comfortable making a high volume of outbound calls daily.Preferred Experience :
Background in remote care navigation, benefits coordination, or enrollment support.Key Attributes :
Self-starter with a “go-getter” mindset—eager to learn and adapt.Passionate about serving Medicaid and underserved populations.Dependable and punctual—consistently reliable and on time.