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Lead Navigator

at Quality Insights, Inc. in Charleston, West Virginia, United States

Job Description

Quality Insights is searching for a Lead Navigator to join our team!  Navigators educate and assist individuals, families and community partners in understanding insurance options as available through the Health Insurance Marketplace, part of the Affordable Care Act, and provide assistance in completing the application process.  The Lead Navigator will assist the Project Manager by serving as the team liaison to ensure Navigator questions and needs are addressed and that the call center is adequately staffed to respond to consumers' requests for assistance in a timely manner.  The Lead will also assist in the identification of new community partners and events to ensure grant enrollment and outreach goals are met.  S/he will be responsible for attending community events on a rotating schedule with other Navigators, as well as having the ability to attend events on short notice.  

 

Role and Responsibilities:

Lead 

  • Respond to individual Navigator questions and notify Project Manager when further assistance is needed or an issue should be discussed during a team meeting.
  • Create draft Navigator schedule based on staff and Finesse license availability to ensure consumers' requests are addressed in a timely manner. Call volume will also be taken into consideration to limit PRN hours during periods when call volume is low and increase PRN hours when volume is expected to be high (near the end of the open enrollment period).
  • Serve as the liaison for Navigators to share positive and negative interactions and collect documentation of the same for the monthly report.
  • Assist Project Manager with onboarding and training new Navigators.
  • Assist Project Manager with new community partner outreach as needed.

Navigator

  • Assist consumers in need of health insurance coverage with application preparation to establish eligibility and enrollment in Marketplace coverage. 
  • Provides outreach and education to raise awareness about the Marketplace, referring consumers to health insurance ombudsman and consumer assistance programs, as necessary.
  • Explain the Marketplace application process, program requirements, and timelines to interested consumers, accurately and in understandable terms.
  • Utilize various mediums (phone, virtual, outreach events, etc.) to provide consumers technical assistance during open enrollment timeframes as determined by federal and state guidelines.
  • Interview individual consumers to obtain information needed to apply for insurance and potential payment assistance programs
  • Assist with uploading application documents, submitting appeals and other consumer focused assistance.
  • Regularly participate in community events to increase awareness of health insurance and develop partnerships.
  • Provide presentations/educational sessions to potential clients and community partners.
  • Provide referrals to other assisters, the Exchange Call Center, or other resources.  Also provide referrals to meet other social determinants of health criteria (e.g., housing insecurity) of consumers by collaborating with local shelters and outreach centers, as necessary.
  • Assume and maintain responsibility for Navigator program supplies and equipment, and manage all supplies/equipment as directed.
  • Other duties as assigned.
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Job Posting: 870022

Posted On: Nov 10, 2021

Updated On: Dec 10, 2021