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Social Services Representative, Advanced

3 months ago


Long Beach, United States Blue Shield of California Full time

Your Role
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. The Social Services Representative regularly reaches out to members and/or family members with the goal of assessing social service needs, and coordinating support aimed towards improving member quality of care. The Social Services Representative coordinates with team members and other internal departments, as well as providing the first line of telephonic response for incoming calls to the Social 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, file 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.
Coordinate 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 ExperienceHigh School Diploma required5 years of relevant work experience2 years of experience with Medi-Cal managed care, including Cal MediConnect and MedicareRequires broad knowledge of operational systems and practices typically gained through extensive experience and/or educationBachelor’s Degree in Social Work or equivalent preferredMay require vocational or technical education in addition to prior work experienceKnowledge of governmental and private organizations, resources in the community, laws, regulations and policies preferredExperience working with or for a manage health care plan preferredEffective time management skills and ability to define and act on priorities efficiently preferredSkilled in establishing rapport with members. Ability to plan and execute work effectively. Ability to express ideas clearly and concisely preferredExcellent analytical skills. Excellent communication skills both orally and in writing with all levels of BSC Promise staff, members, contracted physicians, and participating provider groups preferredPay 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-MM4