Field Health Benefit Representative (Facilitated Enroller)

Centene Management Company • Monroe, 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 100% field based in Orange County, New York, and requires compliance with the Affordable Care Act, FE Integrity Guidelines, regulatory guidelines, and Fidelis Care standards, with a strong focus on customer experience and community engagement.

The representative provides culturally and linguistically appropriate assistance, maintains accurate application and activity records in required systems, and safeguards confidential and protected health information. The role requires evening and weekend work, participation in training and ongoing recertification, and completion of NY State of Health approved training and certification. Applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship.

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 become certified.
• Complete all required annual recertification courses and learning.
• Authorized to work in the United States without the need for current or future employment-based visa sponsorship.
• Must work evenings and weekends.
• Valid driver's license is mandatory for non-NYC counties; preferred for NYC counties.

Nice To Haves

• Fluency in Spanish is highly preferred.
• Two or more years of prior experience in managed care, sales, customer service, or a related area is preferred.
• A driver's license is preferred for 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, including how benefits vary by income level.
• 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 and 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 tracking tool with detailed representative activity.
• Monitor applications in the personal dashboard and follow up promptly and accurately with applicants and potential leads.
• Keep current with Marketplace functionality and manage individual accounts effectively.
• Follow up on new enrollment leads and consumer inquiries, and record dispositions accurately and promptly in the required CRM.
• Enter applicant demographic, enrollment site, and PCP selection data in the required CRM at the initial enrollment encounter.
• Comply with conflict-of-interest standards and regulations.
• Safeguard confidential information and protected health information against unauthorized access, in compliance with privacy and security standards.
• Participate in required trainings, updates, webinars, and other forums needed to carry out the role.
• Meet annual Marketplace Facilitated Enroller recertification requirements and keep current with industry and regulatory updates concerning the ACA and Marketplace.
• 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 all policies and standards.

Benefits

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

What This Job Offers

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