Member Health Engagement Specialist

Western Health AdvantageSacramento, CA
$70,304 - $75,000Onsite

About The Position

Western Health Advantage is seeking a compassionate, resourceful Member Health Engagement Specialist to lead member-focused outreach and navigation. This position helps members address preventive care gaps, chronic conditions, elevated health risks, behavioral health needs, and health-related social barriers. You’ll combine direct member engagement with available data to identify trends, uncover barriers, and recommend practical improvements that strengthen access, health equity, member experience, and outcomes.

Requirements

  • Bachelor’s degree in Public Health, Community Health, Health Education, Social Work, Human Services, Psychology, Sociology, Healthcare Administration, Medical Assisting, or a related health or human services field. An equivalent combination of education and relevant experience may be considered.
  • Three or more years of progressively responsible experience in Population Health, healthcare navigation, care coordination, health education, community health, member or patient engagement, social services, behavioral health, SDOH/resource navigation, managed care, or related healthcare services.
  • Demonstrated experience independently engaging and navigating members or patients with preventive care needs, chronic conditions, health-related social needs, or barriers to accessing care.
  • Experience reviewing member or program information to identify patterns, barriers, trends, and opportunities for improvement.
  • Strong communication, customer service, relationship-building, analytical, organizational, and time-management skills.

Nice To Haves

  • Experience working with a health plan, managed care organization, Medical Group, healthcare delivery system, or community-based organization.
  • Familiarity with Population Health, HEDIS and preventive care, chronic-condition programs, behavioral health screening, health equity, and community resources.
  • Experience with motivational interviewing, health coaching, behavior-change communication, or similar member-engagement techniques.
  • Community Health Worker, health education, care coordination, or a related certification.

Responsibilities

  • Lead targeted member outreach for Population Health initiatives, including preventive care gaps, chronic conditions, utilization patterns, and elevated health risks.
  • Educate members about preventive care, wellness, disease management, behavioral health, and other health-related programs and resources.
  • Provide individualized navigation to help members overcome barriers to care, program participation, and recommended health actions.
  • Manage closed-loop follow-up on member needs and referrals, helping confirm successful connections to appropriate care and resources.
  • Screen for health-related social needs and connect members with community resources and community-based organizations.
  • Administer approved behavioral health screening tools, including the PHQ-2, and facilitate appropriate referrals or escalation.
  • Coordinate with Medical Groups, internal departments, vendors, and healthcare partners to support continuity of care.
  • Review outreach, care-gap, referral, screening, utilization, and program information to identify trends and improvement opportunities.
  • Translate member feedback and frontline observations into recommendations for outreach strategies, communications, navigation workflows, and health-equity interventions.
  • Partner with Population Health Analysts, the Population Health Program Specialist, Case Management, and clinical resources on coordinated initiatives.
  • Accurately document member outreach, barriers, referrals, interventions, follow-up, and outcomes.
  • Independently manage assigned priorities and proactively communicate risks, barriers, trends, and opportunities to Population Health leadership.

Benefits

  • Equal employment opportunities
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