Live-agent member outreach for health plans
Your quality team already knows which members have open care gaps. The harder question is whether you have enough outreach capacity to keep working them toward a scheduled appointment or next step.
30+ years supporting healthcare organizations · US-based physical call centers · Bilingual live agents · Medicare & Medicaid experience
The reframe
Identifying the right member is only the first step. Someone still has to reach that member, have the conversation, and try again when the first attempt does not work.
The challenge may not be finding members who need action. It may be creating enough successful human interactions to move them toward it.
The list treats them the same. Your outreach team does not.
Same open gap. Very different outreach workload. Now multiply Member B across thousands of members.
The real workload is not how many members are on the list. It is how much outreach it takes to move them from identification, to engagement, to action.
How much more could your highest-value resources accomplish if they could focus on the work that actually requires their expertise?
You keep the clinical judgment and the workflow. We add the outreach hours it takes to actually move members.
GMS Connect handles the outreach work.
Your team stays focused on the work that requires their expertise.
Targeted, repeated, bilingual outreach pointed at the members you're having the hardest time moving.
The Member B population: the one your care managers keep circling back to. This is exactly the workload capacity is built for.
You don't have to start with your entire member population. Start with the one your team is having the hardest time moving.
Structured, transparent, and shaped around your workflow, not a black box.
Members, objective, action, timing, languages, and requirements.
Approved scripts, contact protocols, training, scheduling, escalation, reporting.
Trained live agents begin working the population — repeated attempts and callbacks.
Guide engaged members toward the defined action, such as scheduling.
Visibility into activity, outcomes, and cases needing internal escalation.
Start with one population. Build the workflow around your needs. Add capacity where you need it.
Healthcare outreach is not ordinary consumer calling. It touches protected health information, vulnerable populations, and your plan's reputation. The controls behind the call matter as much as the call itself.
Independent validation of the controls protecting sensitive information.
Healthcare outreach is not new to us. GMS Connect has supported healthcare organizations since 1992.
For more than three decades, GMS Connect has supported major health plans with member communication and outreach involving sensitive information, diverse populations, and complex campaign requirements.
The Member Outreach Capacity Assessment is a working conversation, not a sales pitch. You don't need to know how much capacity you need. Bring one population and we'll look at the challenge together.
We'll walk through population size, desired action, outreach requirements, language needs, timeline, existing resources, and likely contact workload, so you can see the real effort behind the list.
No requirement to replace your internal team.
No requirement to replace an existing vendor.
No need to outsource your entire population.
Select a time that works for you.
