EPSDT and Healthy Behavior Outreach Specialist

Job Title: EPSDT and Healthy Behavior Outreach Specialist

Reports to: Outreach Director (Internal); Client Site Manager (External point of contact)

Location: Washington, DC – H Street Office (Hybrid: 4 days in office, 1 day remote)

Position Type: Full-Time (2 Positions)

Date: June 2026

Exempt Status: Non-Exempt

General Summary

The EPSDT and Healthy Behavior Outreach Specialist plays a vital role in WellCentric DC's partnership with its client to improve health outcomes for Medicaid-enrolled children and families across the District of Columbia. This position is responsible for conducting targeted telephonic and community-based outreach to connect families with preventive care services, including well-child visits, dental screenings, lead testing, and immunizations. The Specialist serves as a trusted community liaison, removing barriers to care and helping families navigate the healthcare system with confidence.

Working under the day-to-day supervision of the client manager, the Outreach Specialist will implement a multi-pronged engagement strategy designed to bring families into compliance with EPSDT and other Healthy Behavior requirements. This role requires close collaboration with Wellpoint DC's Case Management team and active participation in the EPSDT workgroup to ensure outreach insights inform program strategy. The position requires a high level of self-motivation, cultural competence, and commitment to health equity. Bilingual candidates are strongly encouraged to apply.

Essential Duties and Responsibilities

 According to the ADA 1990, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Outreach and Member Engagement

• Conduct telephonic outreach to Medicaid enrollees whose children are out of compliance with EPSDT requirements, including well-child visits, dental screenings, lead testing, and immunizations.
• Schedule appointments on behalf of members and coordinate transportation as needed to reduce barriers to care.
• Follow up with families to confirm appointment completion and address ongoing barriers.
• Log into the Genesys Cloud System immediately upon clocking in each workday.
• Update CPSUI for Do Not Call (DNC) entries and wrong numbers in accordance with established procedures.
• Use client-provided call scripts and approved FAQ materials for all member interactions.

Community Presence and Education

• Participate in community wellness events to educate families about EPSDT services, healthy behaviors, and available incentives.
• Serve as an accessible, knowledgeable resource to help enrollees understand the importance of preventive health services.
• Educate staff at physicians' offices regarding HEDIS timeliness expectations when scheduling appointments.

Care Coordination and Navigation

• Assist members with Primary Care Provider (PCP) changes and ID card requests.
• Help families identify Specialists and Ancillary providers needed to complete identified services.
• Identify and track Social Determinants of Health (SDOH) during telephonic outreach and connect callers with available community resources.
• Ensure appropriate referral and follow-up support for enrollees requiring additional pediatric case management services, coordinating directly with the client's Case Management team.

Partnership Development

• Collaborate with local health centers, schools, and community organizations to strengthen referral pathways and promote EPSDT services through trusted community channels.

Data Tracking and Reporting

• Document all outreach activities and outcomes using client’s designated tracking tools (including CPSUI and other assigned systems).
• Maintain accurate records of call attempts, outreach outcomes, appointment schedules, and transportation coordination.
• Report outreach trends, issues, and successes at client's EPSDT workgroup meetings.
• Support data analysis and continuous improvement efforts as directed.

Performance Goals  (Expectations)                       

Metric                                          Meet    Exceeds                              

Calls per week                        350   500

Appts. Scheduled per Week   17     30  

Qualifications

•  High school diploma or GED required; Associate's or Bachelor's degree in Public Health, Social Work, Human Services, or a related field preferred.
• Minimum of 1-2 years of experience in community outreach, health education, care coordination, or a related role.
• Familiarity with Medicaid managed care, EPSDT, and/or Healthy Behavior programs strongly preferred.
• Experience with telephonic outreach or call center environments preferred.
• Demonstrated ability to work independently and lead oneself with minimal direction.
• Proficiency in Microsoft Office Suite; ability to learn and navigate health plan systems (e.g., Genesys Cloud, CPSUI).
• Valid driver's license and reliable transportation required.
• Bilingual skills a plus (Spanish preferred).

Behaviors

• Proficient Oral and Written Communication
• Customer Service Oriented
• Demonstrates Strong Attention to Detail
• Teamwork and Collaboration
• Critical Judgment
• Organizational Skills
• Time Management
• Professional Image
• Cultural Competence and Health Equity Mindset

Physical Requirements

•  Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
• Hearing: Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to interpret the information accurately.
• Repetitive motion: Substantial movements (motions) of the wrists, hands, and/or fingers.
• Medium work: Exerting up to 40 pounds of force occasionally, and/or up to 20 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.
• Periods sitting at a desk and working on a computer.
• Frequent periods of walking.
• The worker is required to have close visual acuity to perform activities such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; and extensive reading.
• The worker is not substantially exposed to adverse environmental conditions.

Work Environment

 This is a hybrid position based in the NE H Street location in Washington, DC, 4 days per week in the office and 1 day remote. Staff will also work in the field, participating in community wellness events and partnering with local health organizations throughout the District. The sensitivity level of information handled in this role is high; all staff are expected to adhere to HIPAA requirements and WellCentric DC's confidentiality policies.

Work Schedule

• Full-Time | Monday through Friday
• Hybrid: 4 days in office at the H Street NE DC location, 1 day remote

Other Duties

 This job description is intended to describe the general nature and work performed by employees but is not a complete list of activities, duties, or responsibilities required of personnel. Furthermore, other duties, responsibilities, and activities may change or be assigned at the employer's discretion.

Direct Reports

 No direct reports.

EEO Statement

Wellcentric DC is an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. We are committed to a policy of nondiscrimination, inclusion, and equal opportunity, and actively seek a diverse pool of candidates in this search.