Senior Care Account Executive Springfield

Senior Care Options Account Executive - Spanish Preferred - Springfield Overview

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Navi Care is a program for people age 65 and older, who live in our service area, and who have Mass Health Standard, and may have Medicare.

It combines Mass Health (Medicaid) and Medicare benefits, including prescription drug coverage. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique.

Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region.

This position requires that the Account Executive achieves personal referral and outreach goals for the Navi Care program. Manages a territory and group of referral source accounts, providing regular follow up and overcoming barriers with each account to meet enrollment goals.

• Relationship Building:
  Creates productive and collaborative relationships with internal and external referral sources in order to obtain qualified referrals and enrollments for the Navi Care program.
• Participation in community outreach activities (senior fairs, community events, elder services professional association events) to ensure Fallon Health’s visibility and presence in the territory.
• Presents the Navi Care program to groups who are likely prospects, caregivers and community referral sources.
• Develops and implements their own territory business development plan and carries out activities to penetrate accounts listed on the plan.
• Lead Generation:
  Works collaboratively with Navicare enrollment team to discuss progress of referrals and ideas for resolving issues.
• Provides inservice orientations to vendors and providers on an annual basis.
• Shows accountability and follows up with prospects until the lead is closed/withdrawn and documents as appropriate. Achieves monthly referral and home visit request goals.
• Secure Applications:
  Generates sufficient Navi Care enrollment applications to meet monthly enrollment goals.
• Explains the Navi Care program clearly and consistently to prospects and their families to ensure that prospects enroll with a solid understanding of the program, maintaining a low disenrollment rate. Meets with Navi Care prospects in their homes.
• Completes application and other documentation needed; submits all completed applications in a timely manner as required by CMS.
• Tracking & Reporting:
  Documents all sales activities in the department’s CRM application and account management grid in a timely manner.
• Meets weekly sales activity deliverables consistently, and tracks these in the CRM and their Outlook calendar.
• Maintains records of Navi Care applications and documentation related to scopes of appointments.
• Assessment:
  Regularly reviews effectiveness of efforts against goals. Provides market intelligence to the Navi Care/ Manager and the Outreach Director so that adjustments can be made to tactical plans.
• Regulatory Guidelines:
  Operates within the marketing and outreach guidelines and regulations provided by CMS and EOHHS. Retains Scope of Appointment and other Enrollment Records. Submits information on Navi Care prospect events to Outreach Support in a timely manner, for CMS submission. When in doubt, asks questions pertaining to compliance or privacy regulations.
• Must meet monthly, quarterly and year end enrollment goals. Maintains a minimum number of activities and events designed to generate leads for enrollments. Keeps up to date…