Social Services Representative, Advanced

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.

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: 

• Establish 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
• Provide telephonic support to members and/or family members following their discharges from inpatient facilities
• 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.  
• Actively participates in Interdisciplinary Team Meetings and provides updates on member’s ongoing needs and progress, and intervention recommendations
• 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 and a broad knowledge of operational systems and practices typically gained through extensive experience and/or education 
• Bachelor’s Degree in Social Work or equivalent preferred
• Requires minimum of 5 years of experience. May require vocational or technical education in addition to prior work experience
• Minimum 2 years of experience with Medi-Cal managed care including Cal MediConnect and Medicare
• 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. 
• 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

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.