Social Services Representative, Advanced

Your Role 

The Social Service Representative, Advanced will report to the Supervisor, Social Services. In this role you will be providing telephonic social services support and resource referrals for Blue Shield Promise members, in addition to administrative support to the Social Services Management Team. The Social Services Representative, Advanced 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, Advanced, 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.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
 

Your Work 
In this role, you will:

• 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
• 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 
• 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 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 
   

Your Knowledge and Experience 

• Requires a High School diploma or GED or 1 year of additional relevant experience in lieu of a diploma 
• Requires 5 years of relevant experience 
• Demonstrated 2 years of experience with Medi-Cal managed care including Cal MediConnect and Medicare 
• Applied broad knowledge of operational systems and practices gained through experience and/or education
• Bachelor's Degree in Social Work or equivalent preferred 
• Proficient skills with computer programs, including Microsoft Excel, Outlook, Word, and PowerPoint 
• Excellent communication skills both orally and in writing
• Knowledge of health disparities in diverse communities 
• Effective time management skills and ability to define and act on priorities amid multiple responsibilities 
• Experience working with Medi-Cal populations preferred 
• Bilingual Spanish speaking preferred

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.