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Community Resource Center Representative
4 weeks ago
The Blue Shield Promise Community Resource Center (CRC) Representative plays a vital role in connecting members with health plan benefits and social services. This position is located at our Wilmington Community Resource Center and requires the employee to work 5 days a week in the Wilmington Community Resource Center.
Key Responsibilities- Resolve issues and inquiries concerning members' eligibility, benefits, provider information, clinical, pharmacy, and other health or social service needs.
- Compose routine and non-routine correspondence to answer benefits/provider inquiries in writing.
- Coordinate membership changes such as members' primary care physician.
- Analyze available programs, determine program eligibility, and connect members to appropriate BSC vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists.
- Conduct outreach calls and activities to inform members about the Community Resource Centers, how to access health plan benefits, and assist with scheduling appointments.
- Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs or services when appropriate.
- Assist with organization and hosting of unique quality events and participating in on-site, off-site Community Resource Center activities.
- Requires at least 3 years of professional experience.
- Requires broad knowledge of operational systems and practices typically gained through extensive experience and/or education.
- Requires being bilingual in Spanish as demonstrated by successful completion of an oral language proficiency test.
- Requires at least 6 months of experience with Medi-Cal enrollment guidelines, specifically Medi-Cal renewal/redetermination process.
- Requires customer service background.
- Must demonstrate a positive attitude, flexibility, professionalism, and dependability in all workplace activities.
