Senior Health Benefit Rep

Centene Corporation • New York, NY

1d • $27 - $49 • Onsite

About The Position

The Senior Health Benefit Representative (SHBR) educates and assists individuals with 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 helps existing members with renewals and benefit education. 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.

This is a field-based position working in Queens, New York. Fluency in Mandarin is highly preferred. The role requires evening and weekend work. The representative also mentors staff, may serve as a point of contact or team lead, and builds relationships with providers and community-based organizations. 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.
• Must complete and pass the NY State of Health-approved training program and become certified.
• Must complete required annual recertification courses and learnings.
• 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

• Fluency in Mandarin.
• Four to five years of prior experience in managed care, sales, customer service, or a related field.
• Driver's license for NYC counties.

Responsibilities

• Educate and assist individuals enrolling in NY State of Health Marketplace coverage, including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans, and Health & Recovery Plan.
• Explain public-program eligibility, federal premium tax credits, cost-sharing reductions, plan features, benefits, cost-sharing mechanisms, and Marketplace metal tiers.
• Teach members how to use Fidelis digital tools, including the member portal and mobile app.
• 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.
• Handle complex customer cases and escalated issues with advanced problem-solving and empathy.
• Provide culturally and linguistically appropriate assistance.
• Conduct public education activities and presentations, and participate in ACA forums, workshops, and community events.
• Maintain a daily activity tracking tool and monitor the personal dashboard to ensure timely, accurate follow-through on applications and leads.
• Review the personal dashboard daily and follow up on potential leads and consumer inquiries.
• Keep abreast of Marketplace functionalities and industry and regulatory updates related to the ACA and Marketplace.
• 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.
• Work evenings and weekends.
• Mentor new and existing staff, supporting onboarding and skill development.
• Serve as a point of contact or team lead when necessary, providing guidance and coordination.
• Collaborate with leadership and the training team to develop and implement practices that enhance community and provider engagement.
• Build and maintain strategic partnerships with providers and community-based organizations.
• Represent Fidelis Care professionally by leading presentations, workshops, and training sessions; generate self-sourced leads through community relationships and referrals.
• Safeguard confidential information and protected health information from unauthorized access.
• Participate in required trainings, updates, webinars, and other forums.
• Complete annual Marketplace Facilitated Enroller recertification requirements.
• 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

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

What This Job Offers

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