Community Resource Center Representative

3 days ago

Long Beach, California, United States Blue Shield of California Full time
About the Role

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.

Job Summary

The Community Resource Center (CRC) team is responsible for managing the Blue Shield Promise Health Plan Information Resource Center (IRC) and jointly operating CRCs throughout Los Angeles County with L.A. Care. The IRC and CRCs connect members from both Blue Shield Promise and L.A. Care health plans, and the Los Angeles community, to classes and personalized services that foster community connections, address social needs, and keep people active, healthy, and informed.

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 physicians. May participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction.
  • 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.
Requirements
  • 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.
Pay and Benefits

The pay range for this role is: $20.47 to $28.66 for California.

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.

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