Health Benefits Navigator (Remote)

Healthcare Benefits Navigator (Remote - U.S. Based)

Location: Remote (United States Only)

Job Type: Full-Time

Pay: Starting at $15.00 per hour

About PharmaCentra

PharmaCentra is a healthcare services organization dedicated to improving the member experience through education, advocacy, and support. We partner with healthcare organizations and benefit programs to help members understand their healthcare options, navigate complex benefit programs, complete enrollment activities, and access healthcare resources.

We are seeking compassionate, service-focused Healthcare Benefits Navigators to provide exceptional support to individuals enrolled in employer-sponsored healthcare programs.

Position Summary

The Healthcare Benefits Navigator serves as a trusted resource and educator for members seeking assistance with healthcare benefits, enrollment support, healthcare navigation, pharmacy benefits, and issue resolution. This role provides education and guidance while delivering a high-touch member experience.

This is a non-licensed position. Team members provide education, navigation, and support but do not provide licensed insurance advice. Activities requiring licensure are escalated to licensed professionals.

Essential Responsibilities

Benefits Education & Guidance

• Explain health plan options and benefit structures.
• Educate members regarding deductibles, copays, coinsurance, provider networks, and coverage options.
• Support member understanding of ICHRA and employer-sponsored healthcare benefits.
• Help members make informed healthcare decisions through education and guidance.

Enrollment Support

• Guide members through enrollment activities.
• Assist with applications and required documentation.
• Verify information and assist in resolving enrollment-related concerns.
• Monitor enrollment progress and conduct follow-up activities as needed.

Healthcare Navigation

• Answer healthcare benefit and coverage questions.
• Assist members in locating providers, specialists, pharmacies, and healthcare resources.
• Support understanding of pharmacy benefits and medication access.

Member Outreach

• Conduct outbound outreach activities during Open Enrollment and throughout the year.
• Follow up with eligible members who have not completed enrollment.
• Provide reminders regarding required actions and deadlines.
• Re-engage members who discontinue enrollment activities.

Documentation & Case Management

• Document member interactions and next steps.
• Maintain accurate case notes and records.
• Identify member barriers, concerns, and trends.
• Support quality assurance and reporting initiatives.

Required Qualifications

• High School Diploma or GED.
• Minimum one (1) year of experience in healthcare customer service, health insurance, PBM member services, Medicare support, benefits administration, healthcare call center operations, or a related field.
• Strong verbal and written communication skills.
• Ability to simplify complex healthcare concepts for consumers.
• Strong documentation and organizational skills.
• Ability to efficiently navigate multiple computer applications simultaneously.
• Ability to work independently in a remote environment.

Preferred Qualifications

• PBM Member Services experience.
• Health Plan Member Services experience.
• Benefits enrollment experience.
• Medicare support experience.
• ICHRA, HRA, TPA, or benefits administration experience.
• Healthcare advocacy or patient navigation experience.

Remote Work Requirements

This position is fully remote and must be performed from within the United States.

Please note that PharmaCentra is not able to hire in every U.S. state. Applicants must reside and perform all work in a state where PharmaCentra is authorized and able to employ workers for this position. Eligible work locations may change at any time to ensure ongoing compliance with legal and regulatory requirements.

Employees must maintain a dedicated, professional, and secure workspace that protects confidential and proprietary information while supporting uninterrupted job performance. Working from public locations, including coffee shops, libraries, coworking spaces, or other public environments, is not permitted while conducting Company business.

Employees are expected to maintain a work environment that complies with all Company privacy, security, and confidentiality requirements. Work may only be performed from an approved U.S. work location. Any temporary or permanent change in work location must be approved by the Company in advance. Employees may not perform work outside the United States unless expressly authorized in writing by PharmaCentra.

Equipment Requirements

As this is a fully remote position, team members are required to provide and maintain their own equipment.

Minimum requirements include:

• Windows 10 or Windows 11 (64-bit) computer
• Minimum 8 GB RAM
• Quad-core processor
• At least 50 GB available storage
• Second monitor with 1920 x 1080 resolution
• USB noise-canceling headset with microphone
• Webcam
• Keyboard and mouse
• Two available USB-A ports
• One available HDMI port

Applicants must have administrative access to the computer they intend to use for work.

Internet Requirements

Applicants must maintain:

• Minimum 50+ Mbps download speed
• Minimum 50+ Mbps upload speed

Reliable wired internet service is strongly preferred.

Workspace & Technology Verification

As part of the interview process for remote positions, candidates are asked to briefly demonstrate their intended workspace and computer equipment.

This allows PharmaCentra to verify that the workspace meets privacy, security, equipment, and connectivity requirements.

Candidates should be prepared to:

• Briefly show their intended workspace during a video interview.
• Disable virtual backgrounds, video filters, or other technologies that obscure the environment.
• Demonstrate that required equipment and internet connectivity standards can be met.

Candidates who receive a contingent offer of employment may also be asked to permit Company-authorized personnel to remotely access their computer for legitimate business purposes, including:

• Verification of technical requirements.
• Security and compatibility verification.
• Installation and configuration of Company-approved software.
• Validation of required system settings needed to perform job duties.

Benefits

Immediately Available

• DailyPay

After 90 Days of Employment

• Paid Time Off (PTO)
• Paid Holidays
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Company-Paid Short-Term Disability (STD)
• Company-Paid Long-Term Disability (LTD)
• Company-Paid Life Insurance

After 12 Months of Service

• 401(k) Retirement Plan
• Employer Matching Contributions
• Immediate Vesting of Employer Match

Benefits are subject to eligibility requirements and applicable plan documents.

Equal Employment Opportunity

PharmaCentra is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Employment decisions are made without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable law.

Reasonable accommodations are available for qualified individuals with disabilities throughout the application and employment process.

Offer of employment is conditioned upon passing a background check.