Social Services Representative, Advanced

4 weeks ago

Lakewood, United States Blue Shield Of California Full time

Your Role Apply below after reading through all the details and supporting information regarding this job opportunity. The Social Services Representative, Advanced will report to the Supervisor, Social Services. In this role you will provide telephonic social services support and resource referrals for high acuity Blue Shield Promise members, in addition to administrative support to the Social Services Management Team.TheSocialServicesRepresentativeregularlyreachesoutto membersand/orfamilymembers with the goal of assessing social service needs, and coordinating support aimed towards improving member quality of care. The Social Services Representativecoordinates with team members and other internal departments, as well as providingthefirstlineoftelephonic responseforincoming calls to theSocial Services department. Your Work In this role, you will: Be responsible for establishing trusting relationships with members while providing person-centered support and services Conduct telephonic social determinants of health needs assessment with high acuity members to address social barriers and care gaps As a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.) Provide members and/or family members with care coordination, referrals and linkage to Health Plan resources and community agencies Document screenings, assessments, referrals and case notes in the electronic case management and tracking systems within the established department guidelines Provide telephonic support to member and/ or family members following their discharges from hospitals and other medical facilities. Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independently Prepare and complete logs and reports as needed for meetings and audits Any other assigned duties Your Knowledge and Experience High School Diploma required Bachelor’s Degree in Social Work or equivalent preferred Requires broad knowledge of operational systems and practices typically gained through extensive experience and/or education Typically, requires minimum of 5 years of experience. May require vocational or technical education in addition to prior work experience Minimum two (2) years of experience with Medi-Cal managed care including Cal MediConnect and Medicare preferred Knowledge of governmental and private organizations, resources in the community, laws, regulations and policies preferred Experience working with or for a manage health care planpreferred Effective time management skills and ability to define and act on priorities efficiently preferred Skill in establishing rapport with members. Ability to plan and execute work effectively. Ability to express ideas clearly and concisely preferred Excellent analytical skills. Excellent communication skills both orally and in writing with all levels of BSC Promise staff, members, contracted physicians, and participating provider groups preferred Pay Range The pay range for this role is: $ 20.82 to $ 29.15 for California. Note Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles. #LI-EB1

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