Careers

We're looking for action-oriented, entrepreneurial people that want to be part of the latest innovation in healthcare – one that will provide more affordable insurance benefits to hundreds of thousands of people.

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    Health Republic Insurance of New Jersey (HRINJ) is a new, nonprofit, member-driven health plan with just one mission: to bring quality, affordable health insurance to independent workers, small businesses, and others not offered employee-sponsored health plans in New Jersey. 

    We are constantly exploring new ideas in a fast-paced and fun work environment, and are looking for people who can creatively help drive important health market reforms.  

  • Health Republic Insurance of New Jersey (HRINJ) is seeking a CMS Technical Coordinator, responsible for identifying and building HRINJ organizational relationships with technical CMS (Centers for Medicare and Medicaid Services) decision makers and information sources. He or she will attend and document all CMS technical discussions, seminars/webinars, and events, and provide applicable feedback and actionable items to stakeholders, such as internal staff and key vendor partners.

    Responsibilities:

    • Regularly participate in all CMS technical discussions, seminars/webinars, and events, for a total of about 20 hours per week.
    • Identify key roles at CMS, and establish positive and productive working relationships with key staff members at CMS.
    • Develop, implement and monitor systems for ensuring all aspects of CMS guidance are clearly understood by internal and external partners at HRINJ.
    • Document and distribute all technical information as provided by CMS to appropriate HRINJ staff members and key vendor partners.
    • Ensure ongoing, timely resolution of emergent problems and issues for HRINJ and its key vendors as related to CMS.
    • Act as an internal resource for resolution of all technical considerations under CMS’s domain.
    • Develop a schedule of CMS calls of all types, including technical, and ensure HRINJ has appropriate and adequate representation on all calls.
    • Record and report back on topics, subjects and actionable items to all applicable HRINJ staff members and related key vendor partners.
    • Perform other related functions as needed or required.

     

    Skills and Qualifications:

    • Requires minimum Bachelor’s degree in Business/Management, Communications, or English.
    • IT experience preferred, but not required.
    • Basic understanding of how eligibility and claims data move between systems (e.g. 834, 837).
    • Basic understanding of how enrollment and claims systems function, especially in a distributed environment.
    • Detail-oriented with significant documentation and outlining skills.
    • Knowledge of Microsoft Office applications including Outlook, Word, Excel, and Access.
    • Self-motivated and disciplined with a strong work ethic.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Financial Analyst with experience in health insurance or hospital finance to forecast and track trends in health insurance claims utilization.  He or she prepares analyses and reports to support Finance Department reporting to the New Jersey Department of Banking and Insurance (NJ DOBI).  The Financial Analyst anticipates and reports to senior management regarding budgetary outcomes.

    Responsibilities:

    • Reviews claims activity and engages in complex analyses based on various demographics, i.e., age, sex, etc.
    • Identifies and tracks trends in claims utilization and identifies various indicators affecting claims costs.
    • Collects and prepares analyses of financial data for reporting to the New Jersey Department of Banking and Insurance (NJ DOBI).
    • Queries, analyzes, and designs reports from company enrollment records and health claims data warehouse.
    • Tracks and analyzes percentage premium costs vs. percentage claims costs on an ongoing basis.
    • Analyzes medical expenses and applies business metrics to determining health insurance premiums.
    • Translates numbers into recommendations for reducing per-member, per-month costs.
    • Makes budgetary projections, forecasting where numbers are expected to be on- and off-target, and prepares periodic financial reports for internal review.
    • Prepares reports for and delivers PowerPoint presentations to internal and external stakeholders.

     

    Skills and Qualifications:

    • Bachelor’s degree with 3 to 5 years relevant work experience.
    • Familiarity with claims data and ICD-9 and CPT codes, with the ability to research and analyze medical data trends.
    • Detail-oriented with good judgment and knowledge of overall business metrics.
    • Strong oral and written communication skills, with the ability to conduct presentations for small to large group meetings.
    • Experience with billing for various types of health insurance or hospital claims.
    • Ability to interact with various levels of management as well as clients.
    • Experience interacting with bureaucratic entities to gather data and information.
    • Skilled in Microsoft Excel, Access, Word and PowerPoint.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Data Integrity Analyst to implement ongoing requirements pertaining to all aspects of the organization’s Qualified Health Plan (QHP) functions related to the Federal Facilitated Marketplace (FFM). The Data Integrity Analyst will collaborate with key partners to ensure all federal, internal and external requirements are executed according to schedule. Key partners include, but are not limited the Centers for Medicaid and Medicare Services (CMS), The NJ Department of Banking and Insurance (DOBI), The US Department of Health & Human Services (HHS), third party vendors, consultants, etc.

    Responsibilities:

    • Responsible for day-to-day oversight and implementation of program needs and deliverables, including specified templates, financial templates, ad-hoc write ups, tracking documents, and other forms as required; Provides regular, periodic status updates to supervisor on all projects.
    • Works with staff across the organization to identify operational and business impacts of new, existing, and revised regulations, develops recommendations, documents potential business opportunities and challenges, and presents information to management team and other designated staff.
    • Mitigates project conflicts and resource allocation issues.
    • Monitors requests and regulations related to the FFM and maintains databases to include most current information.
    • Provides administrative and technical support to the management team including report generation, presentation preparation, maintenance of files, etc.
    • Attend Exchange-related project meetings, and updates management team on key items; disseminates technical information as required.
    • Interacts with regulatory agencies for clarification, interpretation, and/or additional information related to agency requests and published regulations.

     

    Skills and Qualifications:

    • Bachelor’s degree required.
    • Prior health insurance experience required with 3-5 years of professional level analytical experience.
    • Experience working with health plan enrollment process and knowledge of HIPAA, PPACA, and/or FFMs preferred.
    • Ability to review, analyze, and interpret regulatory requirements in clear and concise manner.
    • Decisive with ability to exercise good judgment under pressure.
    • Ability to manage competing responsibilities and meet multiple, simultaneous deadlines.
    • Demonstrated ability to work and communicate effectively with employees at all levels.
    • Detail-oriented with strong organizational skills and excellent data analysis, reporting and presentation skills.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Market Research Analyst who will be primarily responsible for sourcing and interpreting data, extraction of critical insights, strategy creation, and developing best practices around the significant use of market data. This will include formulating reports and making recommendations based upon research findings to help drive and achieve organizational goals. This role is within the marketing and sales department and identifies critical trends, industry intelligence, and opportunities and threats, while informing forecasting and strategic efforts..

    The successful candidate will:

    • Have previous work experience in marketing, sales or business.
    • Have a solid understanding of traditional, digital and syndicated research tools and meticulous attention to detail.
    • Demonstrate an instinctive knowledge of what an audience needs when presenting ideas and research concepts.
    • Maximize available research tools/resources to make decisions; recommend new approaches when necessary.
    • Have the ability to communicate in a timely, concise and direct manner.
    • Possess a sense of humor and the capacity to support the mission, focus and growth of the first and only healthcare CO-OP in the state of New Jersey.

    Responsibilities:

    • Collect and analyze data insights on market conditions, customer demographics, preferences, needs, and buying habits to identify potential markets and factors affecting product demand and for use in marketing and sales planning.
    • Follow health trends and become an expert in understanding significant trends/leanings in health reform.
    • Prepare reports of findings, illustrating data graphically and translating complex findings into written text.
    • Measure and assess customer feedback via discrete channels, such as website and social media.
    • Identify market intelligence gaps.
    • Gather statistical data on competitors and analyze prices, sales and marketing strategies.
    • Forecast and track marketing and sales trends.
    • Measure the effectiveness of marketing, advertising, and communications programs and strategies.
    • Work closely with sales and marketing, developing consultative relationships with this staff and strategic plans for the use of market and competitive information and the impact on the organization.

     

    Skills and Qualifications:

    • Bachelor’s Degree, preferably higher, in marketing/market research, business, economics, or related field.
    • 4+ years’ experience within the health insurance industry, or other similar environments.
    • Internet research skills, and abilities using spreadsheets, PowerPoint, and other software.
    • Knowledge of competitive and market analysis tools and statistics.
    • Excellent written and verbal communication skills.
    • Skilled at influencing and collaborating with all levels of an organization.
    • Self-motivated with the ability to support a team approach in using data to bring about positive company results.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Member Engagement and Outreach Associate to join the Member Engagement and Marketing team, with a focus on the southern part of New Jersey. The Associate will report to the Manager of Member Engagement and focus on conducting outreach with community stakeholders and other organizations in this region.

    This staff member will work with locally-based groups in the Southern Tier to educate them on health reform and the marketplace/exchange, as well as the CO-OP. All Member Engagement and Outreach Associates are required to obtain a License to sell Health and Accident Insurance in the state of New Jersey within 3 months of date of hire, if not in possession of this License when they join HRINJ.

    Responsibilities:

    • Conduct outreach calls and identify and visit targeted geographic areas and hubs with potential members to ensure there is an understanding of HRINJ and its benefits, and to emphasize the importance of health care for those who are uninsured.
    • Identify and follow up with a broad array of generated leads, including those received from other staff.
    • Receive research, review and streamline processes, and track all incoming lead referrals and recruitment efforts.
    • Assist with development and coordination of events and other community activities that meet established criteria for optimal outreach.
    • Provide feedback on how to best reach local community using paid/unpaid media.
    • Work with volunteers and other community partners in identifying opportunities for member engagement.
    • Assist in preparing and submitting projects, reports or assignments as needed to meet organizational objectives.
    • Perform other duties as assigned.

     

    Skills and Qualifications:

    • B. A. or B.S. degree required.
    • Must be in possession of or able to attain a New Jersey State Health & Accident Insurance License within the first 3 months of employment.
    • Strong experience managing organizational outreach and member marketing efforts for a member-driven constituency, health plan or other relevant company.
    • Ability to travel frequently and regularly to and throughout the southern part of New Jersey.
    • 3-5 years of marketing, outreach and/or community organizing experience.
    • Proficiency in Microsoft Office Suite, including PowerPoint, Word, Excel, etc.
    • Excellent written and verbal communication skills.
    • Expert familiarity and agility using new and emerging communication/social media technologies.
    • Ability to manage and contribute to multiple projects, both individual and team-based.
    • Must have a collaborative work style and entrepreneurial spirit.
    • Must be available to participate in offsite meetings and events during weekday evenings and on weekends as needed or required.
    • Knowledge of Salesforce software preferred.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Member Services Specialist with the ability to work independently and provide superior, high-level member service. He or she will assume the following job responsibilities.

    Responsibilities:

    • Respond to telephone inquiries directly from members and from HRINJ vendors regarding medical claims, pharmacy claims, billing, and enrollment issues.
    • Address and resolve member inquiries and escalations received via the HRINJ Call Center or from the Federal Exchange.
    • Work with HRINJ team members from other departments to resolve member issues.
    • Ensure members are serviced in the utmost professional manner, as well as build and maintain exceptional relationships with all contacts.
    • Act as liaison between the HRINJ Call Center and the Management team.
    • Provide guidance to Member Service Representatives on procedures to follow to address member inquiries.
    • Assist Member Services Manager in collecting service activity data and analyzing reports to review quality metrics.
    • Support Member Services Manager in identifying service improvement opportunities and monitoring Service Level Agreements.
    • Assume additional duties as requested.

     

    Skills and Qualifications:

    • Must be a team player with strong analytical and interpersonal skills.
    • Must be detail-oriented and member-focused, with good follow-through skills and the ability to see an issue through to its resolution.
    • Experience in call center/member services environment preferred.
    • Must have excellent communication skills, both spoken and written.
    • Must have the ability to work independently with minimal guidance and stay calm under pressure.
    • Strong organizational, time management and multi-tasking skills.
    • Must have cross-functional capability and be flexible, with the ability to adapt quickly to change.
    • Knowledgeable in Office productivity software (Excel, Word, etc.) and computer-savvy.
    • Bilingual (Spanish) is preferred.
    • Experience in the Health Insurance industry and/or knowledge of applicable terminology is a plus.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking an Office Coordinator to serve as the primary point person for office communications and operations. The office coordinator present a professional, welcoming first contact to all staff, consultants, vendors, board members, and members of the public– by phone and in person. The office coordinator ensures that the office runs smoothly, staff has some level of administrative support, and facilities are maintained.

    This position includes answering phones and receiving visitors, maintaining adequate supply levels, ensuring proper functioning of office equipment, etc. She or he oversees break room maintenance, advises building staff of repair needs, and assists staff as needed.

    Reception Responsibilities:

    • Performs receptionist activities, including answering phones and transferring calls; receiving visitors and directing them to correct staff person(s); responding to or referring customer inquiries as needed, while presenting a member-friendly demeanor at all times.
    • Responsible for incoming and outgoing mail, shipping and receiving.
    • Maintain office/cubicle allocation for traveling staff, visiting consultants and vendors.
    • Manage parking spot allocation for staff and guests.
    • Maintains office supply inventory by regularly submitting office supply orders and assisting staff with special orders.

     

    Office and Facilities Support:

    • Responsibility for development & implementation of efficient office systems.
    • Responsible for keeping office equipment maintained.
    • Responsible for organizational functions and general meeting support: maintaining office space schedules, securing food and supplies, copying and faxing.
    • Act as the liaison between HRINJ and building staff, including the maintenance of a facilities log for repairs, upgrades, and improvements to ensure physical plant and common spaces is in good working order condition.
    • Responsible for managing supplies and ensuring common areas, such as kitchen are kept in good working order, running of dishwasher, and copy room maintenance.
    • Provide support for staff travel arrangements.

     

    Administrative Support:

    • Implement ongoing improvements to office/administrative procedures.
    • Assemble and maintain documented office procedures for use by new hires and existing staff.
    • Perform other related duties as assigned or directed.

     

    Skills and Qualifications:

    • Minimum Associate’s degree, with at least five years’ experience in office administration; Bachelor’s degree preferred. Education may be replaced with experience.
    • Excellent organizational skills with attention to detail and effective problem solving skills.
    • Proficiency in Microsoft Office, including Word, Excel, Outlook and PowerPoint.
    • Ability to work independently with little or no supervision and to interact effectively with staff and outside agencies.
    • Well-developed interpersonal and communication skills with customer service orientation.
    • Excellent time management skills and ability to multitask while prioritizing work.
    • Prior customer service experience preferred.
    • Bilingual preferred (Spanish-English).
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a talented Quality Data Analyst to monitor processes and systems improvement databases. He or she evaluates the impact of quality program activities and performance indicators that lead to improved quality of care and patient health outcomes. The Data Analyst supports Population Health program goals and objectives for HRINJ Health Plans, and ensures that members are engaged with actionable opportunities for health management and improvement.

    Responsibilities:

    • Manages projects, HEDIS, CAHPS and Quality Improvement (QI) data collection using data management software.
    • Provides subject matter expertise on data integrity and integration.
    • Researches, analyzes, interprets and maps QI data workflows for new and ongoing disease state measures/programs.
    • Presents at Quality Improvement Committees, identifying targeted areas for discussion and assisting with mechanisms to demonstrate improvement.
    • Assists with coordination of vendor quality interventions and troubleshoots data-related issues and concerns as they arise.
    • Assists with development and reporting of member/provider communications, e.g., push educational and reminder notifications, community resources, provider report cards, etc.
    • Collaborates with the Medical Director and across improvement teams to evaluate QI program quality effectiveness in improving quality of care.
    • Works with the Quality and Population Health Director to assess performance indicators of patient health outcomes.
    • Monitors claims data against projections to ensure that Population Health Program and QI activities achieve objectives.
    • Supports member, provider chart reviews, and external regulatory activities.
    • Assists with other quality-related activities as needed.

     

    Skills and Qualifications:

    • Bachelor’s degree, with experience in healthcare and/or related field.
    • Demonstrated ability to manage continuous quality improvement, including collection and analysis of data and implementation of proposed solutions.
    • Knowledge of principles related to meaningful use and quality improvement.
    • Ability to analyze and present data to groups and individuals.
    • Excellent time management skills with attention to detail and effective organizational and communication skills.
    • Must have experience with HEDIS, CAHPS and QI data collection using data management software.
  • Health Republic Insurance of New Jersey (HRINJ) is seeking a Vendor Data Analyst to support the Vendor Relations Manager in addressing challenges presented by various health insurance vendors, such as billing/enrollment, pharmacy benefit manager, etc., as HRINJ grows. The Vendor Data Analyst provides interpretive data from HRINJ’s current vendors to the Vendor Relations Manager. He or she is responsible for gathering data from vendors and preparing reports to assess and identify areas for improvement. 

    Responsibilities:

    • Identify key individuals within vendor organizations with whom to partner in support of vendor relations management.
    • Establish collaborative relationships and interact regularly with identified individuals for purposes of gathering data and engaging in analyses.
    • Develop methodologies using Microsoft Excel and Access for collecting, collating and analyzing data from vendor partners.
    • Collect and organize data from each vendor and provide regular reports to Vendor Relations Manager.
    • Analyze enrollment claims data for discussion with Vendor Relations Manager and determination of courses of action required for performance improvement.
    • Review processes and identify weaknesses and areas of improvement.
    • Interact regularly and schedule calls, meetings, etc., as needed with identified individuals within vendor organizations for discussion of areas for improvement.
    • Prepare vendor data reports for review by HRINJ executives and managers.

     

    Skills and Qualifications:

    • Bachelor’s degree required.
    • Proficiency with Microsoft Excel required and Access preferred.
    • 1-3 years experience in the Health Insurance industry preferred.
    • Good problem-solving and organizational skills with the ability to interact with individuals at all levels.
    • Strong analytical skills with the ability to accurately interpret and report data findings.
    • Excellent written and verbal communication skills.
  • To apply:
    Email resume and cover letter with salary requirements to resume@newjersey.healthrepublic.usWe review resumes on a rolling basis, so you may submit your resume to us at any time for general consideration.

    Equal Employment Opportunity and Accommodation Statement:
    Qualified applicants are considered for all positions without regard to race, creed, color, religion, sex (including pregnancy and gender identity), sexual orientation, familial status, national origin, ancestry, age, marital status, domestic partnership or civil union status, affectional or sexual orientation, gender identity or expression, atypical hereditary cellular or blood trait, family medical history or genetic information, liability for military service, mental or physical disability, perceived disability, AIDS and HIV status, and any other legally protected status. Women and minorities are especially encouraged to apply.  If you require disability accommodation to apply for this position, please contact the Human Resources Manager at 201.244.4755.