Counselor Jobs

About The Position

Requirements

• Associate’s degree.
• Obtain NY State of Health Assistor/Navigator Certification within the first weeks of hire and pass the certification exam with a score of at least 80% before any client contact.
• If not already certified, demonstrate the ability and willingness to obtain certification within 30 days of hire.
• Strong communication skills, including the ability to explain complex eligibility and coverage information clearly and impartially.
• Strong interpersonal skills and ability to build rapport and trust with diverse patient populations.

Nice To Haves

• Prior NY State of Health Assistor/Navigator certification.
• Relevant healthcare, social services, or care-management credentials such as Certified Application Counselor (CAC), CPHQ, or CCM.
• One to two years of direct experience with Medicaid enrollment, recertification, eligibility determination, care coordination, or healthcare case management.
• Experience navigating the NY State of Health Marketplace or doing Certified Application Counselor or Navigator work.
• Experience with HRSN screening, Social Care Network programs, or similar systems-navigation work.
• Knowledge of Medicaid, Medicare, Essential Plan, Qualified Health Plans, managed care, and health insurance processes.
• Familiarity with MAGI and non-MAGI eligibility, Medicaid spenddown, and APTC reconciliation.
• Comfort with frequent phone-based outreach and follow-up.
• Familiarity with EHR systems, preferably eCW.
• Previous experience in outreach, community engagement, enrollment, or social services.
• Understanding of HIPAA, 45 CFR §155.260, and patient privacy requirements.
• Fluency in Spanish and English.

Responsibilities

• Coordinate care for patients with multiple chronic conditions through Health Home, Health Home Plus, HARP, and related programs across NYREACH’s clinical and community partner network.
• Assist enrolled and transitioning patients with Medicaid recertifications and renewals, including six-month renewal requirements under H.R. 1, to help prevent coverage gaps.
• Screen insurance status, identify eligibility gaps and approaching renewal deadlines, and conduct outreach to at-risk patients.
• Complete and submit new applications and renewals through the NY State of Health enrollment portal, collecting and uploading required documentation.
• Explain Medicaid, Essential Plan, and Qualified Health Plan options, out-of-pocket costs, metal tiers, advance premium tax credits, and appeals and complaints processes, while remaining neutral in plan selection.
• Help patients meet and document H.R. 1 Community Engagement requirements and identify and document applicable exemptions.
• Assist mixed-status and undocumented households, address public charge concerns, and connect eligible household members to appropriate coverage.
• Manage appointment scheduling, text and call reminders, and follow-up to reduce no-shows and maintain appointment availability within established timeframes.
• Provide same-day appeal referrals and same-day referrals to the Local Department of Social Services for non-MAGI applicants.
• Maintain accurate and timely documentation in NYSOH and the EHR, protect personally identifiable information under HIPAA and 45 CFR §155.260, and follow Navigator/Assistor conflict-of-interest standards.
• Meet monthly application and renewal targets and quality benchmarks, including application completion, documentation upload at submission, and no-show rates.
• As assigned, provide one-on-one SHOP enrollment assistance to eligible small employers and educate them about the federal Small Business Health Care Tax Credit.