Job Description

Title: Patient Care Advocate

Location: Remote Pacific Time Zone (Nationally sourced candidates must be willing to work PST hours)
Duration: 8 Months Contract
Schedule: Mon Fri | Standard Shift | 8 hours/day | No OT
Interview Process: Teams/Phone Interview + Typing & Computer Literacy Test Required
Pay Range: $25.00 - $30.00 Per hr. on w2.

Job Summary

We are seeking a Patient Care Advocate to support member outreach initiatives focused on improving preventive care compliance, closing care gaps, and enhancing the overall member experience. This role will work closely with members, providers, and internal departments to support HEDIS and quality improvement initiatives across Medicaid, Medicare, and Marketplace lines of business.
The ideal candidate will have strong outbound call experience, managed care knowledge, HEDIS exposure, and the ability to work independently in a remote environment while meeting high-volume outreach metrics.

Key Responsibilities

• Conduct high-volume outbound outreach calls to members to close gaps in preventive care services
• Educate members regarding the importance of preventive screenings, wellness visits, and healthcare compliance
• Schedule and confirm appointments for members needing preventive care services
• Assist members with transportation coordination and wraparound services
• Serve as a liaison between members, providers, and internal departments
• Support HEDIS quality initiatives and provider/member engagement activities
• Conduct telephonic outreach and health coaching activities
• Document all member interactions accurately within internal systems
• Collaborate with provider relations, customer service, case management, and disease management teams
• Assist in resolving member concerns and barriers to care
• Support provider offices with education related to HEDIS measures and coding practices
• Participate in quality improvement projects and special assignments
• Maintain confidentiality of protected health information (PHI)
• Meet daily outreach and appointment scheduling productivity goals

Typical Day

• Complete outreach calls to Medicaid, Medicare, and Marketplace members
• Educate members on preventive care and wellness screenings
• Coordinate appointments and follow-up services
• Work cross-functionally to resolve member issues
• Document activities and update systems accurately
• Daily productivity expectations:
  • 95+ outbound calls/day
  • 14 16 appointments scheduled/confirmed daily

Required Qualifications

• Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related healthcare field
  
  OR
• Equivalent combination of education and experience (Total 4+ years)

Required Experience

• 2+ years of experience in:
  • Direct patient care
  • Social work
  • Health coaching
  • Quality improvement
  • Managed care environment
• High-volume outbound calling experience
• Experience working remotely with productivity metrics
• Experience handling member outreach and engagement

Preferred Qualifications

One of the following licenses/certifications preferred:

• LPN
• LMSW
• C-SW
• LSW
• RN

Preferred Experience

• HEDIS knowledge
• Managed care experience
• Medicare/Medicaid outreach experience
• Preventive care gap closure initiatives
• Member advocacy and care coordination
• Provider engagement experience

Top Must-Have Skills

1. Ability to work independently in a remote environment while meeting productivity goals
2. High-volume outbound call experience
3. Ability to learn new systems and adapt quickly

Technical Skills

• Microsoft Outlook
• Microsoft Teams
• Microsoft Word
• Microsoft Excel
• EMR/EHR systems
• Care management platforms
• Telephonic outreach systems

Team Culture

• Collaborative and supportive environment
• Strong communication and transparency
• Team-oriented culture focused on improving member outcomes
• Emphasis on accountability, respect, and member satisfaction

Candidate Requirements Snapshot

• Remote role supporting Pacific Time Zone
• Strong outbound call and member engagement background required
• Managed care and HEDIS experience strongly preferred
• Must be self-motivated and metrics-driven
• Comfortable handling sensitive member information

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