Job Overview
Compensation
Salary
Range $70,000.00 - $75,000.00
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Paid Time Off
Retirement Plan
Professional development opportunities
Employee wellness programs
Job Description
Fallon Health is a well-established healthcare company founded in 1977 and based in Worcester, Massachusetts. The company is dedicated to prioritizing the needs of its members, ensuring they receive the care they need and deserve. Fallon Health specializes in delivering equitable, high-quality coordinated care and has consistently been rated among the nation's top health plans for member experience, service, and clinical quality. As a leader in government-sponsored health insurance programs, including Medicare, Medicaid, and PACE, Fallon Health continues to expand and innovate to meet the evolving needs of its community.
One of Fallon Health’s key initiatives is the NaviCare program, designed specifically for individuals aged 65 and older who reside within the service area and have MassHealth Standard, potentially alongside Medicare benefits. NaviCare integrates MassHealth (Medicaid) and Medicare benefits, including prescription drug coverage, to provide comprehensive support for seniors. This program reflects Fallon Health's commitment to embrace diversity and inclusivity, acknowledging the unique characteristics and life experiences of each member they serve. The company actively encourages differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, and socio-economic status, fostering an environment of respect and understanding.
The role of the Account Executive for the NaviCare program at Fallon Health is pivotal in achieving the company’s mission of improving health and inspiring hope. This full-time position is responsible for managing a territory and a group of referral source accounts to meet enrollment goals for the NaviCare program. The Account Executive must develop strong referral relationships and oversee outreach activities, including community events and professional association meetings, ensuring Foolon Health maintains a visible and impactful presence in the community.
Key responsibilities include building collaborative relationships with internal and external stakeholders, presenting the NaviCare program to potential members and caregivers, and developing a strategic business development plan tailored to the assigned territory. The role emphasizes active lead generation by working closely with the enrollment team, providing training to vendors and providers, and maintaining accountability for following up on prospects until enrollment is secured or withdrawn.
Securing applications for enrollment is a fundamental aspect of the position, requiring the Account Executive to thoroughly explain the program to prospects and their families, conduct home visits, complete necessary documentation, and submit applications in compliance with CMS regulations. The role necessitates meticulous tracking and reporting of sales activities using the company’s CRM tools and consistent documentation of all related records.
Assessment and professional development are also integral to the position. The Account Executive regularly evaluates their efforts against goals and market intelligence, collaborating with managers and directors to refine outreach strategies. They are expected to maintain compliance with CMS and state regulatory guidelines, ensure proper retention of all enrollment records, and actively develop new accounts to sustain and grow the program's reach.
In accordance with the Massachusetts Wage Transparency Act, the salary range for this role is $70,000 to $75,000 annually, reflecting the company’s commitment to fair compensation based on experience and skills. Fallon Health is dedicated to equal employment opportunities and prohibits discrimination of any kind, promoting a diverse and inclusive workforce.
This role offers an exciting opportunity for motivated sales professionals with a passion for healthcare and community service, particularly in supporting elderly populations. It combines sales acumen, relationship management, community engagement, and regulatory compliance within a mission-driven organization known for quality and care. Fallon Health provides a supportive environment for career growth and meaningful impact, making the Account Executive position a highly rewarding career choice.
One of Fallon Health’s key initiatives is the NaviCare program, designed specifically for individuals aged 65 and older who reside within the service area and have MassHealth Standard, potentially alongside Medicare benefits. NaviCare integrates MassHealth (Medicaid) and Medicare benefits, including prescription drug coverage, to provide comprehensive support for seniors. This program reflects Fallon Health's commitment to embrace diversity and inclusivity, acknowledging the unique characteristics and life experiences of each member they serve. The company actively encourages differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, and socio-economic status, fostering an environment of respect and understanding.
The role of the Account Executive for the NaviCare program at Fallon Health is pivotal in achieving the company’s mission of improving health and inspiring hope. This full-time position is responsible for managing a territory and a group of referral source accounts to meet enrollment goals for the NaviCare program. The Account Executive must develop strong referral relationships and oversee outreach activities, including community events and professional association meetings, ensuring Foolon Health maintains a visible and impactful presence in the community.
Key responsibilities include building collaborative relationships with internal and external stakeholders, presenting the NaviCare program to potential members and caregivers, and developing a strategic business development plan tailored to the assigned territory. The role emphasizes active lead generation by working closely with the enrollment team, providing training to vendors and providers, and maintaining accountability for following up on prospects until enrollment is secured or withdrawn.
Securing applications for enrollment is a fundamental aspect of the position, requiring the Account Executive to thoroughly explain the program to prospects and their families, conduct home visits, complete necessary documentation, and submit applications in compliance with CMS regulations. The role necessitates meticulous tracking and reporting of sales activities using the company’s CRM tools and consistent documentation of all related records.
Assessment and professional development are also integral to the position. The Account Executive regularly evaluates their efforts against goals and market intelligence, collaborating with managers and directors to refine outreach strategies. They are expected to maintain compliance with CMS and state regulatory guidelines, ensure proper retention of all enrollment records, and actively develop new accounts to sustain and grow the program's reach.
In accordance with the Massachusetts Wage Transparency Act, the salary range for this role is $70,000 to $75,000 annually, reflecting the company’s commitment to fair compensation based on experience and skills. Fallon Health is dedicated to equal employment opportunities and prohibits discrimination of any kind, promoting a diverse and inclusive workforce.
This role offers an exciting opportunity for motivated sales professionals with a passion for healthcare and community service, particularly in supporting elderly populations. It combines sales acumen, relationship management, community engagement, and regulatory compliance within a mission-driven organization known for quality and care. Fallon Health provides a supportive environment for career growth and meaningful impact, making the Account Executive position a highly rewarding career choice.
Job Requirements
- Bachelor’s degree or equivalent experience
- Massachusetts Insurance Producer License (must obtain within 90 days of hire)
- AHIP certification (obtainable before or after hire)
- Minimum 3 years sales experience in healthcare or group insurance
- Proven customer facing sales and lead generation experience
- Knowledge of Medicare, Medicaid, and insurance products preferred
- Understanding of customer service, sales, outreach and marketing
- Valid Massachusetts driver’s license and access to a vehicle
- Ability to manage and develop referral accounts
- Effective communication and presentation skills
- Adherence to CMS and state regulatory guidelines
- Ability to attend community events and meetings
- Timely completion of reports and documentation
Job Qualifications
- BS or BA degree or comparable experience
- Must have or obtain Massachusetts Insurance Producer License within 90 days of hire
- Obtain AHIP certification before or after hire
- Knowledge and experience working with community organizations, low income communities, and the elderly
- Minimum 3 years of sales experience in healthcare or group insurance strongly preferred
- Proven experience in customer facing roles focused on sales and lead generation in a high paced environment
- Knowledge of Medicare, Medicaid, and insurance products desirable
- Understanding of customer service, sales, outreach, and marketing principles and practices
- Valid Massachusetts driver’s license and vehicle for marketing activities and home visits
Job Duties
- Create productive and collaborative relationships with internal and external referral sources to obtain qualified referrals and enrollments for the NaviCare program
- Participate in community outreach activities such as senior fairs, community events, and elder services professional association events to ensure Fallon Health's visibility
- Present the NaviCare program to groups of prospects, caregivers, and community referral sources
- Develop and implement territory business development plans and execute activities to penetrate accounts
- Collaborate with the NaviCare enrollment team to discuss referral progress and resolve issues
- Provide inservice orientations to vendors and providers annually
- Follow up with prospects until leads are closed or withdrawn and document accordingly
- Generate sufficient NaviCare enrollment applications to meet monthly goals
- Explain the NaviCare program clearly to prospects and families, conduct home visits, complete applications, and submit documentation timely as required by CMS
- Document all sales activities in the CRM system and account management grid
- Meet weekly sales activity deliverables and maintain records of applications and documentation
- Regularly review efforts against goals, provide market intelligence, and seek professional development
- Operate within marketing and outreach guidelines and retain required enrollment records
- Submit event information to Outreach Support for CMS submission
- Ensure minimum activity levels and event participation to generate leads
- Maintain at least 10 actively referring accounts and develop 10 new accounts monthly
- Attend all required departmental and collaborative meetings
- Complete reports, documentation, and yearly business plans for the territory on time
Job Criteria
Experience
Mid Level (3-7 years)
Job Location
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