Social Services Representative, Advanced

Social Service Representative, AdvancedThe 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.ResponsibilitiesYour Work In this role, you will:Responsible for establishing trusting relationships with members while providing person-centered support and servicesConduct telephonic social determinants of health needs assessment with high acuity members to address social barriers and care gapsProvide members and/or family members with care coordination, referrals and linkage to Health Plan resources and community agenciesDocument screenings, assessments, referrals and case notes in the electronic case management and tracking systems within the established department guidelinesAs 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 facilitiesCoordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independentlyPrepare and complete logs and reports as needed for meetings and auditsAny other assigned dutiesQualificationsYour Knowledge and ExperienceRequires a High School diploma or GED or 1 year of additional relevant experience in lieu of a diplomaRequires 5 years of relevant experienceDemonstrated 2 years of experience with Medi-Cal managed care including Cal MediConnect and MedicareApplied broad knowledge of operational systems and practices gained through experience and/or educationBachelor's Degree in Social Work or equivalent preferredProficient skills with computer programs, including Microsoft Excel, Outlook, Word, and PowerPointExcellent communication skills both orally and in writingKnowledge of health disparities in diverse communitiesEffective time management skills and ability to define and act on priorities amid multiple responsibilitiesExperience working with Medi-Cal populations preferredBilingual Spanish speaking preferredHybrid Virtual WorkThis role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.About UsAbout Blue Shield of CaliforniaAs of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. 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 achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. 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 listen and communicate effectively, showing empathy by understanding others' perspectives.Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.Our Workplace ModelWe believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:For most teams, this means coming into the office two days per week.Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.Physical Requirements:Office Environment - roles involving part to full time schedule in Office Environment. 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.