Job Description

Your Role

The Social Services Representative, Advanced provides telephonic social services support and resource referrals to Blue Shield D-SNP members, in addition to administrative support to the social service team and Manager/Supervisor. The Social Services Representative, Advanced is regularly reaching 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, Advanced coordinates with team members and other internal departments, as well as provides the first line of telephonic response for incoming calls to the Social Work 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 moderate acuity members to address social barriers and care gaps 
• Provide members and/or family members with care coordination, referrals and linkage to Health Plan resources and community agencies 
• Document assessments, referrals and case notes in the electronic case management and tracking systems within the established department guidelines 
• File and make necessary follow-up on mandated reporting, e.g. Adult Protective Services, Child Protective Services, etc.
• 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. 
• Prepares logs and reports as needed for meetings and audits
• Any other assigned duties

Your Knowledge and Experience

• Requires a High School diploma or equivalent
• Bachelor’s degree preferred 
• Requires at least 5 or more years of prior relevant experience
• Requires at least 2 years of prior relevant experience with a Medi-Cal Managed Health Plan.
• Medi-Cal (Medicaid)/Medicare Experience
• Required experience with managing electronic health records and documenting in clinical case management systems.
• Required excellent communication skills both orally and in writing with all levels of BSC Promise staff, members, contracted physicians, participating provider groups, and community-based organizations. 
• Required effective time management skills and ability to define and act on priorities efficiently
• Desired knowledge of governmental and private organizations, resources in the community, laws, regulations, and policies
• Experience working with or for a managed health care plan
• Bilingual in Spanish required

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-AG3

 

Job Tags

Similar Jobs