Navigator

Overview

The Employee Benefits Navigator serves as a primary point of contact for employees and dependents navigating medical care within the health system. This role answers questions related to health insurance benefits, coverage, and network access; helps employees understand in-network vs. out-of-network care and associated costs; and conducts proactive telephonic and in-person outreach to promote wellness initiatives, preventive care, and available health resources.

• Serve as a primary point of contact for employees and dependents navigating medical care within the health system. Answer questions related to health insurance benefits, coverage, and network access. Assist employees in understanding in-network vs. out-of-network care and associated costs. Conduct proactive telephonic and in-person outreach to promote wellness initiatives, preventive care, and available health resources.
• Support employees during new diagnoses, emergency care transitions, and ongoing treatment plans. Collaborate with Outpatient service lines on scheduling appointments, referrals, diagnostic testing, and follow-up care. Facilitate timely follow-up for diagnostic services and specialty care.
• Coordinate with carriers, TPAs, and internal revenue cycle teams to resolve access or coverage issues.
• Provide wellness education and guidance at on-site New Hire Orientation program.
• Develop wellness education programs for employees through in-person sessions and webinars. Create communication strategy and materials to enhance the health and wellbeing for employees and their dependents.
• Promote wellness vendor platform (Well Works) to encourage employees and their spouses to meet individual health goals and earn prizes. Encourage engagement in disease management, preventive screenings, and wellness programs.
• Maintain accurate documentation of interactions while adhering to HIPAA and confidentiality requirements. Track common barriers, trends, and outcomes to support continuous improvement. Provide insights to HR and clinical partners regarding employee healthcare utilization challenges.
• Other duties and ad-hoc projects as assigned.

• BSN preferred and must be obtained within 3 (three) years from hire date.
• Licensed as a Registered Nurse in the State of New Jersey.
• Experience working in an integrated health system or hospital-based setting.
• Experience in healthcare navigation, care coordination, benefits administration, population health, or patient advocacy.
• Working knowledge of health insurance plans, provider networks, healthcare delivery systems and employee wellness programs.
• Strong interpersonal, communication, and problem-solving skills.
• Ability to manage sensitive information with discretion and professionalism.
• Ability to analyze utilization data and identify opportunities for improvement.

Salary Range: 72,592. USD

We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data
. In addition to base salary, some positions may be eligible for clinical certification pay and shift differentials. The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status.

Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure, healthy lives now and into the future. Benefits include medical, dental, and vision insurance; savings accounts, voluntary benefits, wellness programs and discounts, paid life insurance, generous 401(k) match, adoption assistance, back-up daycare, free onsite parking, and recognition rewards.

You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's.