Employee Health Benefits Navigator

The Employee Health Benefits Navigator is the district's primary contact for employees who need assistance with their medical and prescription benefits. This role requires strong interpersonal skills, sound judgment, and complete discretion.

What You Will Do

The Navigator works closely with carriers, pharmacy benefit managers, providers, and employee health center partners, advocating for employees to receive the care and coverage they are entitled to.

Why It Might Be a Fit

The ideal candidate will have a strong background in health administration, business, human resources, public administration, or a related field, and excellent written and verbal communication skills.

Requirements

• Bachelor's degree in health administration, business, human resources, public administration, or a related field, or equivalent experience.
• Working knowledge of health plan terms and processes, including networks, deductibles, claims, appeals, prior authorization, and pharmacy benefits.
• Knowledge of HIPAA privacy requirements and a record of handling confidential information with discretion.
• Excellent written and verbal communication, with the ability to explain complicated topics simply.
• Strong problem-solving, organizational, and follow-up skills, with the ability to manage many open cases at once.
• Proficiency with Microsoft Office or Google Workspace and with case tracking or benefits systems.
• At least three years of experience in employee benefits administration, health insurance, claims or case management, patient advocacy, or healthcare navigation.
• Experience in a public school district, municipality, or other public employer, including familiarity with the New Jersey School Employees' Health Benefits Program or similar plans.
• Experience with self-funded or partnership health plan models and onsite or near-site health centers. (Preferred)
• Professional credential in benefits or healthcare advocacy, such as CEBS, or a related certification. (Preferred)

Benefits

• Medical, Prescription and Dental Benefits
• Competitive salary
• Paid professional development opportunities
• Competitive benefits package including tuition reimbursement
• Enrollment in the New Jersey Division of Pension and Benefits