Your Role

The Community Programs team provides high-touch engagement with member and community-based organizations to remove barriers to health care access, enhance population health initiatives and advance health equity. The Community Health Advocate - Coordinated Entry System (CES) Liaison will report to the Community Programs Manager, Operations. In this role you will be collaborating, supporting and pursuing connections between Blue Shield Promise and the Coordinated Entry System (CES) lead agencies. You will work collaboratively with local homeless services agencies and other local Continuums of Care (CoCs). In addition, you will assist the CES staff/providers with connecting members to the appropriate Blue Shield Promise resources and Blue Shield Promise staff with connecting members with the right resources within the CES system.

Please note, this is a Short-Term Employment Opportunity.

Your Work

In this role, you will:

• Assess psychosocial and social determinants of health needs for un-housed high-risk members, connect to appropriate services and document assessment results or augment available information in appropriate systems
• Consult with or refer un-housed and/or previously un-housed members receiving services through the Coordinated Entry System (CES) to licensed staff (social worker, nurse case manager etc.) as required based on member social, health risk and medical complexity
• Establish relationships and partner with CES staff at the Continuums of Care (CoCs), CES lead agency providers, community resources, 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, and conducting educational sessions on health plan offerings (e.g., benefits, transportation, Community Supports, Enhanced Care Management, etc.)
• Assist members with problem solving barriers to high complexity health conditions by identifying, locating, connecting to and navigating needed community and medical system services, including visiting members at their homes, accompanying members to medical appointments, offering a warm handoff to referring entity, providing follow-up to ensure connection was made, and assisting members with completing forms to access needed services
• Actively engage, build rapport, establish trusting relationships and facilitate collaborative communication with Blue Shield Promise management, external partners, members and member family support systems
• Provide training and support to external partners about Blue Shield Promise resources and programs. Collaborate with Blue Shield Promise Community Supports business units and provide appropriate guidance to match members with appropriate resources. Monitor complex cases to ensure member receives services through the appropriately matched Community Supports Program
• Serve as the liaison between Blue Shield Promise and the CES. Inform internal staff on best practices for collaboration, challenges facing un-housed members and the providers serving the un-housed population. Identify gaps in workflows, processes and systems
• Educate internal staff on the CES processes and how to work effectively with un-housed members and non-contracted un-housed services/housing providers
• Develop and deliver educational presentations on programmatic research and findings to internal and external stakeholders
• Serve as the Blue Shield Promise representative during external stakeholder meetings, participate in standing committees and leadership meetings. Report project status and outcomes to internal and external partners

Your Knowledge and Experience

• Requires a bachelor's degree in Social Work, Psychology, Biology, Public Health, Nursing, Community Health, or Health related field or equivalent experience
• Requires at least 5 years experience working with people who need assistance with complex health and social issues
• Experience working with the un-housed population and with community-based providers required
• Knowledge of Medi-Cal benefits and programs required
• knowledge of San Diego un-housed services, and familiarity with the San Diego Safety Net required
• Skilled at navigating within the health plan / health care system and the un-housed services system required
• Strong problem-solving skills and follow through to ensure case closure required
• Experience assisting providers and members with navigating public programs desired

Pay Range:

The pay range for this role is: $ 77990.00 to $ 116930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.