8hrs a day with 1hr unpaid break
Schedule: To be determined (within client's business hours)
Language Requirement: Fluent in English and Spanish
Position Summary
The Bilingual ECM Outreach Worker serves as the first point of contact for members eligible for Enhanced Care Management (ECM) services. This remote role focuses on educating members about the ECM program, facilitating efficient enrollment, and transitioning them to their assigned Lead Care Manager (LCM). Success in this position requires strong communication skills, cultural sensitivity, and the ability to explain clinical concepts in a relatable, bilingual manner. Spanish fluency is required.
Key Responsibilities
Program knowledge
- Understand the company's Enhanced Care Management (ECM) model, including eligibility criteria, and service offerings.
- Support member onboarding by explaining ECM benefits, care coordination goals, and available resources in both English and Spanish.
- Assist with Outreach & Referral (OR) processes, ensuring timely follow-up and accurate documentation of member engagement.
- Maintain working knowledge of Medi-Cal guidelines, CalAIM initiatives, and the company's interdisciplinary care approach.
- Participate in ongoing training to stay current on program updates, compliance standards, and QI metrics.
Member Outreach & Enrollment
- Make outbound calls to eligible members to introduce and explain the ECM program
- Provide clear, compassionate, and culturally sensitive education about ECM benefits and services
- Encourage member participation and address questions or concerns with empathy and professionalism
- Enroll members into ECM services following established protocols
- Transition enrolled members to their assigned Lead Care Manager (LCM) for ongoing support
Communication & Coordination
- Handle inbound calls from members seeking information or assistance
- Collaborate with care managers, nurses, and administrative staff to ensure smooth handoffs and accurate documentation
- Maintain timely and professional communication with internal teams regarding member status and enrollment outcomes
Documentation & Compliance
- Accurately document member interactions, enrollment status, and relevant notes in the electronic health record (EHR) system
- Verify member eligibility and insurance coverage during the enrollment process
- Always Adhere to HIPAA and company's privacy and security protocols
- Maintain a secure and compliant home office environment, free from public or shared access Remote Work Expectations
- Log in daily via Teams by 8:15 AM (PST) and attend scheduled huddles or meetings
- Submit daily productivity reports and categorized schedules to supervisor by end of day
- Arrange for dependent care during working hours and limit personal tasks to scheduled breaks
- Follow the company's password and data security protocols, including locked storage and regular password updates
Qualifications
- High school diploma and Associate degree in Business Administration, Healthcare, or related field preferred
- Minimum 1–2 years of experience in outreach, enrollment, or care coordination preferred
- Fluent in English and Spanish (written and verbal)
- Basic understanding of clinical terminology and healthcare services
- Excellent verbal communication and interpersonal skills
- Proficient in Microsoft Office Suite and electronic health record systems
- Ability to work independently and manage time effectively
- Strong understanding of HIPAA and confidentiality standards
Technical & Environmental Requirements
- Reliable high-speed internet connection
- Secure workstation with proper lighting, ventilation, and minimal noise
- Access to locked file storage and password-protected devices
- Willingness to comply with the company's IT and security protocols
Independent Contractor Perks
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HMO Coverage for eligible locations
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Permanent work from home
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Immediate hiring