Navicare Inside Sales Representative - Spanish Preferred

Fallon Community Health Plan Worcester , MA 01601

Posted 4 weeks ago

Overview

About Fallon Health

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.

About NaviCare:

Fallon Health is a leader in providing senior care solutions such as NaviCare, a Medicare Advantage Special Needs Plan and Senior Care Options program. Navicare integrates care for adults age 65 and older who are dually eligible for both Medicare and MassHealth Standard. A personalized primary care team manages and coordinates the NaviCare member's health care by working with each member, the member's family and health care providers to ensure the best possible outcomes.

Brief Summary of Purpose:

The primary responsibility of the Inside Sales Representative is to maximize productivity of the Sales team by executing sales and marketing techniques at the corporate office and in the field when necessary; this assists with the growth and retention of NaviCare membership.

Additional responsibilities include targeting key sales opportunities through lead generation for the outreach team. Also, this position will partner with the Sales Outreach team to support external community events. The end result of this position is to help streamline and improve sales tactics and quality of reporting.

Responsibilities

  • Work closely with the NaviCare Government Programs Eligibility team, Aging Service Access Points (ASAPs), and clients to efficiently enroll MH/FEW applications.

  • Assists Manager with training new staff on job responsibilities and EOHHS/CMS Regulations.

  • Primarily responsible for management of NaviCare Marketing ACD Line.

  • Conduct NaviCare telephonic enrollments in accordance with CMS requirements.

  • Effectively manages CRM lead entries, taking responsibility for pending leads over 30 days old through continuous attempts to contact the prospect to engage them with the product and fulfilling prospect requests (i.e. scheduling home visits with an Account Executive, mailing an information packet, etc.)

  • Partner with the sales outreach team on external sales opportunities by attending community event and sales activities. (I.e. Health Fairs, Sponsorship events and Information Tables.)

  • Build relationships with appropriate partners at local Senior Centers, Housing authorities and Nursing Homes. Drop by regularly to ensure all marketing materials are available and promote referrals and lead generation.

  • Demonstrate strong sales skills and willingness to "own" a prospect from start to finish by making contact with an interested prospect, engaging them, and continuously working with them to their final stage of enrollment.

  • Work with management and the outreach team on identifying new business partners that show an interest in selling Navicare products.

  • Handle all BRC leads by mailing out Sales Kits and following up with an outbound call to promote 1-1 or home visit appointments for the Outreach Executives.

  • Adhere to regulatory guidlelines re: Medicare, HIPAA, and Fallon Health patient confidentiality

Maintains a personal touch in all correspondance and communication with prospects.

  • Work very closely with team members to solve customer problem. Offers solutions and suggestions for process and product improvement to management. Determine, understand and meet prospect needs.

  • Assist in training activities as needed.

  • Comply with Corporate,

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License/Certifications License: Active, unrestricted license as a Registered Nurse in Massachusetts & current Driver's license and a vehicle to be used for home visits Certification: Certification in Case Management strongly desired Other: Satisfactory Criminal Offender Record Information (CORI) results Experience * 2+ years of clinical experience as a Registered Nurse working with people up to age 65 with a focus on working with people that are on MassHealth coverage and may be encountering social, economic, and/or multi complex medical and or behavioral health conditions required * IF focused to work with the pregnant member population, 4+ years of clinical experience as a Registered Nurse working with pregnant females during the prenatal, delivery, and postpartum time required * If focused to work with the Cancer Care Program member population, 4+ years of clinical experience as a Registered Nurse working with oncology, hospice, and/or chemo infusion required * Ability to communicate and collaborate with PCP, community and ACO partners to manage members care required * Experience working in a community social service agency, skilled home health care agency, State Agency such as the Department of Mental Health (DMH), Department of Developmental Services (DDS), Department of Children and Families (DCF), and/or the Department of Youth Services (DYS), or other agency servicing those in need preferred Performance Requirements including but not limited to: * Excellent communication and interpersonal skills with members and providers via telephone and in person * Exceptional customer service skills and willingness to assist ensuring timely resolution * Excellent organizational skills and ability to multi-task * Appreciation and adherence to policy and process requirements * Independent learning skills and success with various learning methodologies including but not limited to: self-study, mentoring, classroom, and group education * Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties * Willingness to learn insurance regulatory and accreditation requirements * Knowledgeable about software systems including but not limited to Microsoft Office Products - Excel, Outlook, and Word * Familiar with Excel spreadsheets to manage work and exposure and familiarity with pivot tables * Accurate and timely data entry * Effective case management and care coordination skills and the ability to assess a member's activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member's need * Knowledge about community resources, levels of care, criteria for levels of care and the ability to appropriately develop and impleme Fallon Community Health Plan Worcester MA

Navicare Inside Sales Representative - Spanish Preferred

Fallon Community Health Plan