Cal-Aim Outreach Coordinator

JOB DESCRIPTION

Position: Cal-AimOutreach Coordinator

Pay Range: $24-26

Reporting To: Cal AIM Outreach & Authorization Supervisor

Work Type: Hybrid

POSITION SUMMARY

The Cal-Aim Outreach Coordinator supports the Cal-Aim Department in both remote and in-office settings. This role is responsible for managing incoming referrals, conducting outreach, and coordinating the assignment and processing of referrals for Cal-Aim enrollment. The coordinator ensures timely, accurate handling of referrals while maintaining clear communication with clients, care teams, and health plans.

QUALIFICATIONS

1. High school diploma required; certification in a healthcare-related field preferred.
2. Strong communication skills with the ability to effectively engage with diverse populations.
3. Professional phone etiquette and customer service skills.
4. Experience with electronic health record (EHR/EMR) systems and proficiency in Microsoft Word and Excel, including report development.
5. Excellent organizational skills with strong attention to detail and follow-through

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Receive, document, and track incoming referrals, ensuring accurate date stamping and timely processing in accordance with ECM contractual requirements.
2. Review referral documentation for completeness and accuracy and evaluate referrals against ECM and CalAIM eligibility criteria and program guidelines.
3. Conduct outbound outreach to referred members using multiple strategies (phone, SMS, written correspondence, and in-person visits as needed) to assess eligibility, interest, and engagement in ECM services.
4. Perform community-based outreach in alignment with CalAIM ECM guidelines, collaborating with hospitals, clinics, and community partners to engage eligible populations.
5. Educate members, families, and referral sources on ECM/CalAIM services, benefits, and program expectations to support informed enrollment decisions.
6. Create, update, and maintain accurate patient records, including uploading all required documentation into the EMR system.
7. Verify member eligibility and ECM enrollment status, and communicate effectively with Managed Care Plans (MCPs) as needed.
8. Process referrals and coordinate timely follow-up activities, ensuring smooth transitions and warm handoffs to ECM Case Managers and interdisciplinary care teams.
9. Provide timely updates to referral sources, health plans, and internal stakeholders regarding member status and referral outcomes.
10. Monitor referral timelines and outreach activities to ensure compliance with ECM and CalAIM contractual and regulatory requirements.
11. Track, analyze, and report outreach metrics, including engagement efforts, enrollment outcomes, and timeliness of follow-up.
12. Identify and escalate barriers to member engagement (e.g., housing instability, behavioral health needs, or lack of contact information) to appropriate team members.
13. Maintain a strong working knowledge of CalAIM populations of focus, eligibility requirements, and prioritization guidelines.
14. Participate in case conferences, care coordination meetings, and interdisciplinary discussions to support outreach strategies and member engagement.
15. Assist in developing, refining, and improving outreach workflows, scripts, and engagement strategies to enhance enrollment outcomes and operational efficiency.
16. Build and maintain strong relationships with community-based organizations (CBOs), providers, and referral partners to strengthen referral pipelines.
17. Support audits, quality reviews, and compliance activities by ensuring all outreach efforts and documentation meet regulatory and contractual standards.
18. Identify and escalate significant findings, concerns, or trends to the Program Manager as appropriate.

PHYSICAL REQUIREMENTS

• Stand, sit, talk, hear, reach, stoop, kneel and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis, up to 75% of the time.
• Close vision requirements due to computer work.
• Light to moderate lifting may be required up to 25lbs.