Healthcare Navigator

Saint James Health•Newark, NJ

18h

About The Position

The Healthcare Navigator provides eligibility and enrollment assistance for Medicaid, CHIP, and Federal Marketplace health insurance programs to health center patients and community residents. The role conducts outreach and public education about affordable insurance options and the Marketplace, and assists individuals with applications and understanding eligibility for individual plans. The Healthcare Navigator stays current on regulatory guidelines, insurance plan eligibility, authorization, and system requirements. The role helps resolve documentation and enrollment issues, collaborates with the Case Management team on patient-centered communications and process improvements, and serves as a resource for registration and clinical support teams. Additional work includes attending community events, tracking enrollment metrics and patient payments, reconciling electronic work queues, and supporting financial reports, projects, and audits. Other duties may be assigned. Work locations are subject to change.

Requirements

Exchange Enrollment Facilitator Certificate, or completion of training within 30 days.
Strong attention to detail.
Efficient time-management skills.
Excellent analytical and problem-solving skills.
Proficiency with Microsoft Office, especially Excel.
Complete all related training and certifications.

Nice To Haves

Three or more years of healthcare insurance enrollment experience (listed as preferred).

Responsibilities

Conduct outreach and educate health center patients and community members about affordable insurance options and the Marketplace.
Maintain expertise in eligibility, enrollment, and program specifications, and conduct public education activities to raise Marketplace awareness.
Assist individuals with enrollment applications and understanding eligibility for individual plans.
Stay current on regulatory guidelines and insurance plan eligibility, authorization, and system requirements.
Resolve outstanding documentation and enrollment issues, including issues with health insurance companies, and help individuals enroll.
Collaborate with the Case Management team to create patient-centered communication that improves performance and reimbursement and streamlines processes.
Attend community outreach events, health fairs, and informational forums as required.
Assist in tracking enrollment metrics and patient payments.
Monitor and efficiently reconcile electronic work queues.
Provide support for financial reports, projects, and audits as required.
Act as a resource or point person for registration and clinical support teams.
Perform other duties as assigned.