Member Outreach Specialist

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Professional Management Enterprises (PME)

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

📦 Logistics

🎖️ Defense

Healthcare • Logistics • Defense

Professional Management Enterprises (PME) is a multifaceted professional service and personnel staffing company established in 2006. As a Minority and Service Disabled Veteran Owned Business, PME operates in multiple states, partnering with major corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP. The company specializes in staffing, recruiting, and providing services across various sectors, including healthcare, information technology, and administrative support. PME is a key service provider for the Department of Defense and other Federal Government clients, and it leverages its expertise in healthcare, managed care, IT, and human capital services to deliver flexible and high-performing solutions.

📋 Description

• 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 about healthcare benefits, services, programs, and incentives • Assist 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 • Reconnect members with limited healthcare utilization to appropriate care • 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 in 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

🎯 Requirements

• 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 • Ability to work full-time, 40 hours per week • Flexibility for evening or weekend outreach when necessary

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • 80 hours of PTO after 90 days • 10 paid holidays