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 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 role engages uninsured individuals and those seeking new coverage, and supports existing members with renewals and benefit education. Work must comply with the Affordable Care Act, FE Integrity Guidelines, regulatory guidelines, Fidelis Care standards, conflict-of-interest requirements, and privacy and security standards, with a focus on customer experience and community engagement.

This is a field-based position working in the Bronx, New York. The representative provides culturally and linguistically appropriate assistance, conducts public education and presentations, participates in community events, and builds partnerships with providers and community-based organizations. The role also mentors staff, may serve as a point of contact or team lead, and collaborates with leadership and training teams to improve community and provider engagement. Evening and weekend work is required.

Candidates must be authorized to work in the United States without current or future employment-based visa sponsorship. A high school diploma or GED is required. Four to five years of relevant experience is preferred, as is a driver's license for NYC counties; a driver's license is mandatory for non-NYC counties. Candidates must complete and pass the NY State of Health-approved training program and fulfill annual recertification requirements. Pay is $27.02–$48.55 per hour. Centene describes its benefits package as including competitive pay, health insurance, a 401(k) and stock purchase plans, tuition reimbursement, paid time off and holidays, and flexible work arrangements, subject to eligibility and other terms.

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 learning.
• Must be authorized to work in the United States without current or future employment-based visa sponsorship.
• Driver's license is mandatory for non-NYC counties.

Nice To Haves

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

Responsibilities

• Educate and assist individuals enrolling in Marketplace coverage, including NYM, CHP, EP, QHP, and HARP.
• Explain public-program eligibility, federal premium tax credits, cost-sharing reductions, plan features, benefits, deductibles, co-pays, co-insurance, and Marketplace metal tiers.
• Teach members 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 payment submissions when required.
• Support existing members with renewals and recertifications.
• Handle complex customer cases and escalated issues using advanced problem-solving and empathy.
• Provide culturally and linguistically appropriate assistance and protect confidential information and PHI from unauthorized access.
• 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 the personal dashboard to ensure timely follow-through on applications and leads.
• Review the personal dashboard daily and follow up on potential consumer leads and inquiries.
• Keep current with Marketplace functionalities, ACA and Marketplace industry and regulatory updates, and relevant training and webinars.
• 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, applicable privacy requirements, statutes, regulations, policies, and standards.
• Meet annual Marketplace Facilitated Enroller (MFE) recertification requirements.
• Mentor new and existing staff and support onboarding and skill development.
• Serve as a point of contact or team lead when necessary, providing guidance and coordination.
• Collaborate with leadership and training teams to develop and implement practices that improve community and provider engagement.
• Build and maintain strategic partnerships with providers and community-based organizations.
• Represent Fidelis Care by leading presentations, workshops, and training sessions, and generate self-sourced leads through community relationships and referrals.
• Work evenings and weekends.
• Perform other duties as assigned or required by the role.

Benefits

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

What This Job Offers

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