Job Description
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, 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
Qualifications
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 plan preferred
- 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.
About The Team
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.
Two ways of working: Hybrid (our default) and office
- Hybrid – In a business unit approved office a few times per year to 3 days per week, on average
- Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
