Field Health Benefit Rep - Bilingual (Health Navigator)

Centene Management Company • New York City, NY

2d • Onsite

About The Position

The Health Benefit Representative (HBR), also referred to as a Health Navigator, educates and assists individuals with enrolling in affordable health insurance through the NY State of Health Marketplace, including Medicaid (NYM), Child Health Plus (CHP), the Essential Plan (EP), Qualified Health Plans (QHP), and Health & Recovery Plan (HARP). The role engages prospective members who are uninsured or seeking new coverage and supports existing members with renewals and benefit education. Activities must comply with the Affordable Care Act (ACA), FE Integrity Guidelines, regulatory guidelines, Fidelis Care standards, and applicable privacy and security requirements, with an emphasis on customer experience and community engagement.

This is a 100% community field-based role supporting Queens County, NY. The representative provides culturally and linguistically appropriate assistance, conducts education and outreach, monitors applications and leads, and records enrollment and follow-up activity in required systems. The position requires evening and weekend work, participation in training and annual Marketplace Facilitated Enroller recertification, and completion of the NY State of Health-approved training program and certification. A driver’s license is mandatory for non-NYC counties.

Applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship. Sponsorship is not available, including for H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Bilingual South Asian languages—English/Bengali, Hindi, Urdu, Arabic, or Gujarati—are highly preferred.

Requirements

• High school diploma or GED.
• At least 2 years of prior experience in managed care, sales, customer service, or a related area is preferred.
• Basic computer skills.
• Prior public speaking experience.
• Must complete and pass the NY State of Health-approved training program and become certified.
• Must complete all required annual recertification courses and learning.
• Must be authorized to work in the U.S. without current or future employment-based visa sponsorship.
• Must work evenings and weekends.
• Driver’s license is mandatory for non-NYC counties.

Nice To Haves

• Bilingual ability in English/Bengali, Hindi, Urdu, Arabic, or Gujarati; South Asian language skills are highly preferred.
• Community outreach experience.
• Front-facing sales experience.
• Sales or field sales experience.
• Prospecting, tabling, and event experience.
• Microsoft Office Suite skills.
• Salesforce skills.
• CAC Certification is preferred.

Responsibilities

• Educate and assist individuals with enrollment in NY State of Health Marketplace coverage, including Medicaid, Child Health Plus, the Essential Plan, Qualified Health Plans, and Health & Recovery Plan.
• Explain eligibility for public programs, federal premium tax credits, cost-sharing reductions, and possible impacts to consumers.
• Teach members how to use Fidelis digital tools, including the member portal and mobile app.
• Describe plan features, benefits, cost-sharing mechanisms, and Marketplace metal tiers.
• Assist consumers with submitting required documents by scan, fax, or mail, and help with premium payments when required.
• Support existing members with renewals and recertifications.
• Provide culturally and linguistically appropriate assistance to the population served.
• Conduct public education activities and presentations, and participate in ACA forums, workshops, and community events as requested.
• Maintain a daily activity tracking tool and monitor applications in the personal dashboard to ensure timely and accurate follow-through.
• Review the personal dashboard daily and follow up on potential consumer leads and inquiries.
• Keep up to date with Marketplace functionality to manage individual accounts effectively.
• Record follow-up dispositions accurately and promptly in the required CRM.
• Enter applicant demographic, enrollment site, and PCP selection data into the required CRM during the initial enrollment encounter.
• Comply with conflict-of-interest standards and regulations.
• Safeguard confidential information and protected health information from unauthorized access, in accordance with privacy and security standards.
• Participate in trainings, updates, webinars, and other forums relevant to the role.
• Complete annual Marketplace Facilitated Enroller recertification requirements and stay current on ACA and Marketplace regulatory updates.
• Maintain discretion regarding business-related files, reports, and conversations in accordance with applicable state and federal statutes and regulations.
• Perform other assigned duties and comply with applicable policies and standards.

Benefits

• Competitive pay.
• Health insurance.
• 401(k).
• Stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible approach to work, with remote, hybrid, field, or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED