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Community Enrollment Specialist
US-CA - 90079
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Position Summary

Reporting to the Supervisor, Social and Community Relations, the Community Enrollment Specialist will assists patients/clients, either directly or indirectly through referral, enroll into the appropriate coverage program; enrollment/re-enrollment in Medi-Cal, Covered California, Healthy Families, Cal-Fresh and others. Assist with the application enrollment process and provide follow-up to ensure enrollment, utilization, and retention for MLKCH. In addition, process of accessing Public Benefits; develop relationships with community agencies to keep steady flow of new patients into MLKCH. Will educate potential patients about health coverage programs and various private and government-sponsored programs including Medi-Cal, Covered California, Cal-Fresh, and others. Will conduct brief health education/awareness and outreach contacts and encounters. Coordinates enrollment and outreach efforts for businesses with MLKCH growth and reputation initiatives efforts and implements a comprehensive outreach strategy within the community.

Essential Duties And Responsibilities

  • Screen for eligibility and provide assistants to patients/clients enrolling into Medi-Cal, Covered California and developing a systematic referral network plan and execution to assist with MLKCH growth.
  • Assist established and potential patients with establishing care at MLKCH as their primary care home and booking appointment.
  • The Community Enrollment Specialist will be accountable for monitoring, analyzing, and reporting activity against established monthly goal.
  • Run eligibility status for patients/clients through Next Bar Experian and ensure enrollment is assigned correctly under appropriate PCP/Clinic/ Medical Group.
  • Maintain and update all patient/client records in regards to benefits via Revenue Cycle and/or EHR system.
  • Review status and follow up to confirm enrollment, encourage the utilization of health insurance benefits and services.
  • Will provide education and health enrollment assistance to potential patients in the community about healthcare options, including Medi-Cal, Covered California, Healthy Familie, Cal-Fresh and others.
  • Assist those experiencing difficulties (e.g., enrollment troubleshooting and advocacy on behalf of the family, barriers to enrollment, utilization and retention) and offer retention assistance.
  • Identify outreach locations in the community to provide health coverage and other government-sponsored programs.
  • Drives enrollment results through the implementation of the outreach and enrollment plan for the designated area.
  • Make sure that prenatal patients and their newborns are enrolled in Medi-Cal, Covered California, and/or other health care options available.
  • Works with the Supervisor of Social and Community Relations to develop target outcomes for enrollment, outreach initiative, and maintain an extensive awareness of community-based patient resources.
  • Adhere to all policies as set forth by Medi-Cal and Covered California and government-sponsored programs.
  • Prepares monthly community enrollment and outreach report, documenting contacts generated, follow up activities and estimates of resources needed for next strategic steps.
  • Attend/Conduct any community health fairs and other places where people congregate for enrollment assistance and MLKCH growth (including selected weekday and weekend events when assigned).
  • Assists MLKCH growth and reputation initiatives efforts targeting potential patients and eligible community members, including participating in presentations and open enrollment activities.
  • Will have a quota of 20 a month that will be compensated and quota is subject to change based on season.
  • Other duties as assigned


  • Education
  • High school diploma or GED required. Associates Degree, Bachelors Degree, in Healthcare, Business Administration or related field preferred.
  • Certified Application Assister (CAA)
  • Certified Enrollment Counselor (CEC) certification preferred
  • Qualifications/Experience
  • Bilingual English/Spanish required
  • Two (2) or more years of experience working with Medi-Cal, Covered California, health insurance programs and other public benefits.
  • Experience working with individuals from diverse ethnic, educational, cultural and socioeconomic backgrounds, gender identity, sexual orientation.
  • Interest in advocating promoting health care accessibility.
  • Exceptional interpersonal skills and team player.
  • Follow agency policies and maintain organizational standards with regards to patient/client confidentiality and HIPAA compliance.
  • Current valid California Driver License and Insurance Certificate.
  • Special Skills/Knowledge
  • Proficiency in Windows computer software, web-based portal systems, and internet web browsers.
  • Strong verbal and written communication skills and active listening skills.

MLK Community Healthcare

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