Enrollment Navigator

Job Summary
The Enrollment Navigator provides free, unbiased enrollment assistance to individuals and families seeking affordable health insurance through the Get Covered New Jersey Marketplace. The Navigator educates community members about available health coverage options, assists with eligibility determinations and enrollment, and conducts outreach with a focus on the uninsured, underserved, vulnerable, and hard-to-reach populations while ensuring compliance with all federal and state privacy and program requirements. This position duration is from September 1, 2026, to August 31, 2027.

Essential Duties and Responsibilities

• Provide one-on-one assistance to consumers applying for health insurance through Get Covered New Jersey.
• Provide fair, accurate, impartial, and culturally appropriate information regarding all available health coverage options without recommending specific health plans.
• Educate consumers on health insurance concepts including premiums, deductibles, copayments, coinsurance, maximum out-of-pocket costs, tax credits, and available financial assistance programs.
• Assist consumers with completing Marketplace applications, comparing plans, enroll and/or renewing coverage, and reporting life changes.
• Explain health insurance terminology, benefits, and plan comparisons in a clear and culturally sensitive manner.
• Track outreach activities, consumer interactions, enrollments, and performance metrics in accordance with Get Covered New Jersey and grant reporting requirements.
• Assist those who qualify for Medicaid/NJ Family Care and support transitions between NJ Family Care and Marketplace coverage.
• Maintain accurate records within the Get Covered New Jersey platform and ensure proper designation as the consumer's Enrollment Counselor when providing enrollment assistance.
• Protect confidential consumer information in accordance with HIPAA and applicable state and federal regulations. Safeguard Personally Identifiable Information (PII) and Protected Health Information (PHI) in accordance with Marketplace privacy and security standards, federal regulations, and organizational policies.
• Conduct public education activities, workshops, presentations, and community events that increase awareness of Get Covered New Jersey, available financial assistance programs, and health insurance options.
• Conduct targeted outreach and enrollment assistance activities focused on uninsured, underserved, vulnerable, and hard-to-reach populations, including individuals likely eligible for Qualified Health Plans, Advance Premium Tax Credits, New Jersey Health Plan Savings, and NJ FamilyCare.
• Build relationships with healthcare providers, social service agencies, schools, faith-based organizations, and other community partners.
• Meet enrollment goals and performance metrics established by the Navigator program.
• Stay current on Marketplace policies, eligibility guidelines, and annual certification requirements.
• Ensure services are accessible and responsive to individuals with disabilities, limited English proficiency, and varying literacy levels.
• Participate in ongoing training, staff meetings, and professional development activities.
• Provide exceptional customer service while maintaining neutrality and helping consumers make informed decisions.
• Assist consumers with Special Enrollment Period eligibility, Marketplace appeals, documentation requests, eligibility determinations, and resolution of enrollment-related issues.
• Provide referrals to appropriate consumer assistance programs, ombudsman offices, regulatory agencies, legal services organizations, or other resources for consumers with grievances, complaints, appeals, or coverage disputes.

Qualifications

• High school diploma or equivalent required; associate's or bachelor's degree preferred.
• Experience in customer service, community outreach, healthcare, social services, or public benefits preferred.
• Strong communication, interpersonal, and problem-solving skills.
• Ability to explain complex information in a clear, understandable manner.
• Excellent organizational skills and attention to detail.
• Proficiency with computers and online enrollment systems.
• Ability to work independently and as part of a team.
• Bilingual Spanish, Hindi, Gujarati are highly desirable.
• Must successfully complete and maintain all required Get Covered New Jersey Navigator training, certification, and continuing education requirements..

Knowledge, Skills, and Abilities

• Knowledge of health insurance concepts and public assistance programs.
• Commitment to serving diverse populations with professionalism and respect.
• Strong presentation and public speaking skills.
• Ability to maintain confidentiality and handle sensitive information.
• Ability to manage multiple priorities in a fast-paced environment.
• Flexibility to work occasional evenings and weekends for outreach events and open enrollment activities.

Working Conditions

• Office-based with frequent travel throughout the service area for community outreach and enrollment events.
• Participate in extended service hours such as extended evenings and weekends, enrollment events, and community outreach activities during Open Enrollment and other critical enrollment periods as required..
• Ability to sit, stand, and use a computer for extended periods.

Physical Requirements

• Ability to lift and carry outreach materials up to 25 pounds.
• Reliable transportation for community events and partner meetings, if required.

Benefits:

• Company paid employee medical coverage (Eligible after 90 days of continuous employment)
• Access to Dental, Vision, and supplemental benefits through Aflac;
• Access to 403B Retirement Plan.
• Up to 10 days of vacation and 10 days of choice
• All company-paid federal holidays, eligible upon hire.
• Professional Development opportunities