Community Resource Center Representative, Intermediate; Bilingual Spanish - West L

Community Resource Center Representative, Intermediate (Bilingual Spanish) - West L.A.

Blue Shield of California

Position Location:

West L.A. Community Resource Center. The employee must work 5 days per week at the West L.A. Community Resource Center.

The Community Resource Center (CRC) team manages the Blue Shield Promise Health Plan Information Resource Center (IRC) and collaborates with L.A. Care to operate CRCs throughout Los Angeles County. The CRC connects Blue Shield Promise and L.A. Care members with classes and personalized services that foster community connections, address social needs, and keep people active, healthy, and informed. The CRC Representative provides in‑person support to members and consumers who visit a CRC, including health plan member services, benefit explanation, enrollment assistance, referral to social services and care planning, and engagement in select quality events and CRC‑sponsored activities.

• Resolve issues and inquiries concerning member eligibility, benefits, provider information, clinical, pharmacy and other health or social service needs.
• Compose routine and non‑routine correspondence to answer benefits/provider inquiries in writing.
• Coordinate membership changes such as a member’s primary care physician. May participate in quality and efficiency work groups to continuously improve member/customer satisfaction.
• Analyze available programs, determine program eligibility, and connect members to appropriate BSC vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists.
• Conduct outreach calls and activities to inform members about the Community Resource Centers, how to access health plan benefits, and assist with scheduling appointments.
• Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs or services when appropriate.
• Assist with organization and hosting of unique quality events and participation in on‑site and off‑site Community Resource Center activities.

• At least 3 years of professional experience.
• Broad knowledge of operational systems and practices typically gained through extensive experience and/or education.
• Bilingual in Spanish, demonstrated by successful completion of an oral language proficiency test.
• At least 6 months of experience with Medi‑Cal enrollment guidelines, specifically the Medi‑Cal renewal/redetermination process.
• Customer service background.
• Positive attitude, flexibility, professionalism, and dependability in all workplace activities.

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.

Blue Shield of California’s 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.

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 Fair
360 as a Top Regional Company and are one of the 50 most community‑minded companies in the United States by Points of Light.

• Honest – We hold ourselves to the highest ethical and integrity standards, building 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…