Community Resource Center Representative, Intermediate (Bilingual Spanish) - Wilmington

pstrongYour Role/strong/p pistrong*This position is located at ournbsp;Wilmington Community Resource Center Location amp; require employee to work 5 days per week in the Wilmington Community Resource Center*nbsp;/strong/i/p pThe Community Resource Center (CRC) team is responsible for managing the Blue Shield Promise Health Plan Information Resource Center (IRC) and jointly operating CRCs throughout Los Angeles County with L.A. Care. The IRC and CRCs connect members from both Blue Shield Promise and L.A. Care health plans, and the Los Angeles community, to classes and personalized services that foster community connections, address social needs, and keep people active, healthy, and informed. The Blue Shield Promise CRC Representative provides in-person support to Blue Shield Promise members and consumers who visit a CRC. That support includes, but is not limited to, health plan member services, explanation of benefits, linkage to enrollment assistance, and referral to social services and care planning. In addition, the CRC Representative assists with engaging members on select quality events and participating in CRC-sponsored activities./ph3Responsibilities/h3divpstrongYour Work/strong/p pIn this role, you will:/p ul liResolve issues and inquiries concerning members eligibility, benefits, provider information, clinical, pharmacy and other health or social service needs/li liCompose routine and non-routine correspondence to answer benefits/provider inquiries in writing/li liCoordinate membership changes such as member’s primary care physician. May participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction/li liAnalyze available programs, determine program eligibility, and connect member to appropriate BSC vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists/li liConduct outreach calls and activities to inform members about the Community Resource Centers, how to access health plan benefits, and assist with scheduling appointments/li liCoordinates membership changes such as member’s primary care physician/li liVerify the member is included in or targeted for any outreach or care gap programs and connect members to programs or services when appropriate/li liAssist with organization and hosting of unique quality events and participating in on-site, off-site Community Resource Center activities/li /ul/divh3Qualifications/h3divpstrongYour Knowledge and Experience/strong/p ul liRequires at least 3 years of professional experience/li liRequires broad knowledge of operational systems and practices typically gained through extensive experience and/or education/li liRequires being bilingual in Spanish as demonstrated by successful completion of an oral language proficiency test/li liRequires at least 6 months of experience with Medi-Cal enrollment guidelines, specifically Medi-Cal renewal/redetermination process/li liRequires customer service backgroundnbsp;/li liMust demonstrate a positive attitude, flexibility, professionalism, and dependability in all workplace activities/li /ul pnbsp;/p p#LI-AD3/p/divh3About Company/h3divp class="MsoNormal" style="margin: 12pt 0in 0in;"/p p class="MsoNormal"bspanAbout Blue Shield of California/span/b/p p class="MsoNormal"spanAs 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.nbsp;/span/p p class="MsoNormal"spanAt 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.nbsp;/span/p p class="MsoNormal"spanTo 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./span/p p class="MsoNormal"spanBlue Shield isspannbsp;/spana 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!nbsp;spannbsp;/span/span/p p class="MsoNormal"bspanOur Values:nbsp;/span/b/p p class="MsoListParagraphCxSpFirst" style="margin-left:.25in;"/p ul libspanHonest. /span/bspanWe 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.bnbsp;/bb/b/span/li libspanHuman. /span/bspanWe strive to listen and communicate effectively, showing empathy by understanding others' perspectives./span/li libCourageous. /bWe stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.bnbsp;/b/li /ul p class="MsoNormal"bspanOur Workplace Model:/span/b/p p class="MsoNormal"spanAt Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce./span/p p class="MsoNormal"spanTwo Ways of Working:/span/p p class="MsoNormal"/p ul libHybrid (Default):nbsp;/bWork from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above).bnbsp;/bExceptions:/li /ul p/p p class="MsoNormal" style="margin-left:.75in;"spanspanospannbsp;nbsp; /span/span/spanspanMember-facing and approved out-of-state roles remain remote./span/p p class="MsoNormal" style="margin-left:.75in;"spanspanospannbsp;nbsp; /span/span/spanspanEmployees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits./span/p p class="MsoNormal" style="margin-left:.75in;"spanspanospannbsp;nbsp; /span/span/spanspanFor 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./span/p ul libOn-Site:nbsp;/bWork from a business unit-approvednbsp;officenbsp;an average of four (4) or more days a week./li /ul p class="MsoNormal"bspanPhysical Requirements:/span/b/p p class="MsoNormal"spanOffice 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./span/p p class="MsoNormal"spana href="https://www.blueshieldca.com/physical-job-requirements" target="_blank" rel="nofollow"Please click here for further physical requirement detail./anbsp;/span/p p class="MsoNormal"bspanEqual Employment Opportunity:/span/b/p p class="MsoNormal"spanExternal 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./span/p/div