Job Description

Your Role

The Community Health Advocate, Experienced will report to the Manager, Social Services Management and will support the Transitional Care Services (TCS) program by engaging members during and after hospitalization to ensure safe, timely, and effective transition across care settings. In this role you will conduct in person outreach and assessments to Blue Shield of California Promise Health Plan members who are recently hospitalized, currently hospitalized, difficult to reach, and/or identified as high utilizers. The Community Health Advocate, Experienced will serve as a critical bridge between members, providers, and other multidisciplinary care teams to improve engagement, address social drivers of health, and reduce avoidable utilization.

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:

• Conduct in-person outreach to members in hospitals, homes, or community/public settings based on member preferences and accessibility.
• Assess psychosocial and social drivers of health needs for moderate/high risk members and document assessment results or augment available information in appropriate systems.
• Establish relationships and partner with community organizations, health plans and providers by participating in community engagement activities with local agencies e.g. faith-based organizations, community centers, government agencies, parks, recreation centers and schools.
• Assist members with various health conditions problem-solve to address barriers by identifying, locating, connecting to and navigating needed community and medical system services, including accompanying members to medical appointments and assisting members with completing forms to access needed services.
• Actively engage, build rapport and establish trusting relationships and facilitate collaborative communication with members and member family support systems.
• Identify social drivers of health concerns/gaps and develop and document an associated plan to address social and health disparities in accessing appropriate care and services.
• Document member updates and progress notes in appropriate systems, submit timely reports, and provide recommendations for improved member outcomes.
• File and make necessary follow-up on mandated reporting, e.g. Adult Protective Services, Child Protective Services, etc.
• Identify resource gaps in medical and community services and support implementation of new services to close identified gaps.
• Perform other duties, as required

Your Knowledge and Experience

• Bachelor’s degree in Social Work, Psychology, Biology, Public Health, Nursing, Community health or Health-allied field preferred, OR equivalent experience in a related field
• 3 or more years experience working with people who need assistance with complex health and social issues
• Must be able to support our members within Los Angeles or San Diego Counties
• Ability to work independently in a field-based environment with flexible scheduling.
• Valid CA Driver’s License and proof of auto insurance coverage required
• 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 managed care 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.

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