Field Health Benefit Representative (Facilitated Enroller)

Centene Management Company • Elmhurst, NY

4d • Onsite

About The Position

The Field Health Benefit Representative (Facilitated Enroller) educates and assists individuals enrolling in affordable health insurance through the NY State of Health Marketplace, including Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified Health Plans (QHP), and Health & Recovery Plan (HARP). The representative engages prospective members who are uninsured or seeking new coverage and supports existing members with renewals and benefit education. The role is based in the field in Queens, New York, and all activities must comply with the Affordable Care Act, FE Integrity Guidelines, regulatory guidelines, and Fidelis Care standards, with a focus on customer experience and community engagement.

The representative explains program eligibility, premium tax credits, cost-sharing reductions, plan features, metal tiers, and digital tools; helps consumers submit documents and premium payments; and provides culturally and linguistically appropriate assistance. The role also involves community outreach, presentations, enrollment-lead follow-up, application and CRM documentation, dashboard monitoring, protection of confidential and protected health information, and ongoing training and certification. Evening and weekend work is required.

Applicants must be authorized to work in the United States without employment-based visa sponsorship now or in the future. Mandarin fluency is highly preferred; Cantonese or Spanish fluency is preferred. A driver's license is preferred for NYC counties and mandatory for non-NYC counties. The representative must complete and pass the NY State of Health-approved training program and complete required annual recertification.

Requirements

• High school diploma or GED.
• Basic computer skills.
• Prior public speaking experience.
• Complete and pass the NY State of Health-approved training program and obtain certification.
• Complete all required annual recertification courses and learning.
• Work evenings and weekends.
• Be authorized to work in the United States without current or future employment-based visa sponsorship.

Nice To Haves

• Two or more years of prior experience in managed care, sales, customer service, or a related field.
• Fluency in Mandarin.
• Fluency in Cantonese or Spanish.
• Driver's license preferred for NYC counties; mandatory for non-NYC counties.

Responsibilities

• Educate and assist individuals with enrolling in coverage through the NY State of Health Marketplace, including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans, and Health & Recovery Plan.
• Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential 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.
• Support existing members with renewals and recertifications.
• Help consumers submit premium payments when required.
• Provide culturally and linguistically appropriate assistance.
• Conduct public education activities and presentations about Fidelis Care products and Marketplace options.
• Participate in ACA forums, workshops, and community events as requested.
• Maintain a daily tool tracking detailed representative activity.
• Monitor the personal dashboard and follow up on applications and potential leads in a timely and accurate manner.
• Keep current on Marketplace functionality and manage individual accounts effectively.
• Follow up on new enrollment leads and consumer inquiries.
• Record follow-up dispositions accurately and promptly in the required CRM.
• Enter applicant demographic, enrollment-site, and PCP-selection data in the required CRM during the initial enrollment encounter.
• Comply with conflict-of-interest standards and regulations.
• Safeguard confidential information and prevent unauthorized access to protected health information.
• Participate in required training, updates, webinars, and other forums.
• Meet annual Marketplace Facilitated Enroller recertification requirements and stay current on industry and regulatory updates related to the ACA and Marketplace.
• Maintain discretion regarding business-related files, reports, and conversations in accordance with applicable laws and regulations.
• Perform other assigned duties and comply with company policies and standards.

Benefits

• Competitive pay
• Health insurance
• 401(k)
• Stock purchase plans
• Tuition reimbursement
• Paid time off
• Paid holidays
• Flexible approach to work, including remote, hybrid, field, or office work schedules
• Additional forms of incentives may be included in total compensation, subject to eligibility

What This Job Offers

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