Managed Care Engagement Specialists

Job Title
Healthcare Scheduler

Location
Detroit, MI

Type
W2 Contract- $19 an hour 

The Managed Care Engagement Specialist is responsible for proactively scheduling and re-engaging health plan members identified through priority payer lists (e.g., care-gap reports, risk-stratification rosters, and MCO/DWIHN outreach panels) to close gaps in care and support value-based care, quality, and performance metrics. This role conducts outbound outreach, coordinates appointment scheduling across Primary Care, Behavioral Health, and Dental, and documents all engagement activity in the EHR/scheduling system in accordance with policy and applicable confidentiality requirements.

ESSENTIAL DUTIES & RESPONSIBILITES

• Receive, organize, and work assigned priority payer lists (care-gap, HEDIS, risk-stratification, or MCO/DWIHN outreach rosters) on a defined cadence.

• Conduct outbound calls, texts, and/or mailed communications to schedule, reschedule, or confirm appointments for flagged members across PC, BH, and Dental service lines.

• Re-engage members who have missed appointments, lapsed in care, or are overdue for required screenings/visits per payer or CCBHC requirements.

• Document every outreach attempt, outcome, and scheduled encounter in the EHR/scheduling system per documentation standards.

• Coordinate warm hand-offs with Care Coordination, Referral, and BH intake staff when member needs exceed scheduling (e.g., urgent clinical concerns, social needs).

• Track and report individual and panel-level metrics (contact rate, scheduling completion rate, gap-closure rate) to the Manager, Patient Access & Scheduling.

• Partner with the Managed Care/Revenue Cycle liaison to understand current payer priority lists, reporting deadlines, and any changes to targeted quality measures.

• Apply heightened confidentiality protocols when member outreach relates to Behavioral Health or substance use disorder services, consistent with 42 CFR Part 2 and policy.

• Escalate members with safety concerns, urgent clinical needs, or complex barriers to the appropriate clinical or care coordination staff rather than resolving independently.

• Maintain up-to-date knowledge of payer-specific scheduling requirements, insurance verification basics, and appointment types/templates.

• Perform other duties as assigned.

QUALIFICATIONS

Education & Experience

• High School Diploma or GED required; Associate degree preferred.

• Minimum 1–2 years of experience in healthcare scheduling, patient access, call center, or managed care outreach; FQHC or CMH/CCBHC experience preferred.

• Familiarity with managed care concepts (HEDIS gaps in care, MCO/health plan outreach lists, value-based care metrics) strongly preferred.

• Familiarity with Ring Central/Ring Central CX for outbound/inbound calls with Members.

• Experience with EHR/practice management scheduling systems required (such as eCris and Athena).

• Strong verbal communication, active listening, and de-escalation skills for telephonic outreach to members who may be difficult to reach or reengage.

• Bilingual (English/Spanish or Arabic) a plus, reflecting Detroit patient population.

• Demonstrated cultural competency and comfort working with individuals with behavioral health or substance use histories.

• Basic data entry accuracy and comfort tracking productivity against metrics/goals.

Skills & Competencies

• Working knowledge of HIPAA and, specifically, 42 CFR Part 2 confidentiality requirements for BH/SUD-related outreach.

• Ability to manage a high-volume outbound call workload while maintaining accuracy and empathy.

• Strong organizational skills to manage multiple concurrent payer lists and deadlines.

• Ability to work collaboratively with clinical, Revenue Cycle, and Managed Care teams.

• Proficiency with Microsoft Office/Google Workspace and standard office equipment.

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