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 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.

ABOUT THE TEAM

About Blue Shield of California

As 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 Model

We 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.

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.

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