Navicare Jobs (NOW HIRING)

About us:

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 NaviCare is a program for people age 65 and older, who live in our service area, and who have MassHealth Standard, and may have Medicare. It combines MassHealth (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.

Brief summary of purpose:

The Navicare Outreach Operations Coordinator maximizes the productivity of the Navicare Outreach team by providing sales and marketing support that assists in the growth and retention of Navicare members.  You will become a subject expert on presenting, promoting and marketing our programs to all interested; including individuals, groups, community organizations, healthcare professionals etc. Additional responsibilities include the implementation and coordination of retention activities for the Navicare product.    Will serve as liaison with other Departments including Clinical, Provider Relations, NDM and others, to secure information needed, resolve member issues, and secure the completion of all sales opportunities.

Primary Job Responsibilities (include duties that represent 5% or more of employee's time) 

• Develops presentations independently and in collaboration with Communications and Compliance
• Facilitates presentations to various target audiences including prospects, community referral sources and others.
• Attend and assist with the planning of educational, outreach and other health related events. - Coordinate and interact with various roles within , its primary care partners to ensure customer requests, questions and issues are handled appropriately and in a timely manner.
• Assure compliance and adherence with Medicare & Medicaid enrollment and marketing policies and procedures.
• Offers recommendations and suggestions for improvements in office, enrollments, marketing practices etc. to enhance service delivery and customer satisfaction.
• Work closely with Account  Executives to create an event schedule for all Navicare sales activities.
• Maintain event calender and ensure accuracy and documentation into the CRM.
• Maintain the CMS event log.
• Produce various reports for Management.
• Field inbound calls for the Navicare product.
• Maintain working knowledge of competitor benefit information, health care industry trends, and health care reform activities.
• Generate written correspondance and sales packets for prospects as requested. Maintain a personal touch in all correspondance and communication with prospects.    
• Ability to support outside sales representatives at offsite events. Duties include presentations, staffing health fairs and one on one visits. 
• Support the Sales Executives with any administrative requests that helps support our Membership goals.
• Responsible for the preperation/compilation of reports related to the departments key objectives.
• Create internal procedure documents for all operational tasks.
• Become an expert on internal sales systems such as Sharepoint and CRM.
• Create ROI reports on all marketing campaigns for Navicare.
• Generate reports from Fallon Health reporting systems and prepares and distributes reports to NaviCare Outreach managers as needed.
• Generate and analyze reports from various contracted partners including but not limited to:  Long Term Care Facilities, Adult Day Health Care Providers, Adult Foster Care Providers, Physician Practice Sites, and others to ensure Navicare effective penetration of each market.

Job Performance Function(s):

• Engages in extensive contact with all levels of personnel in a professional and confidential manner
• Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee
• Strictly observes HIPPA regulations and the Fallon Health policies regarding confidentiality of member information
• Performs other responsibilities as assigned by the Manager/designee

Education/Experience

Associate’s Degree or equivalent - 2 years experience required - Associates Degree preferred with 2 years of related experience

English required; proficiency in Portuguese and Spanish preferred

License/Certifications

• Current Driver’s License
• AHIP Certificate
• Other:  Satisfactory Criminal Offender Record Information (CORI) results
• Annually:  required to pass a product certification exam.
• Annually: AHIP Certification

Demonstrated proficiency including but not limited to:

• Thorough knowledge of Medicare & Medicaid services, marketing, enrollment policies and guidelines.
• Experience in sales, marketing and customer service preferred.
• Experience working with elders and disabled individuals.
• Knowledge of healthcare systems/services and/or experience with community organizations, social services and public resources.
• Must be a self-starter with a high level of accountability and responsibility.
• Must possess exceptional interpersonal and presentation skills.
• Must be able to meet directly with members, responsible parties and/or providers in office or home settings.
• Must have the ability to work in a multicultural environment and perform outreach related activities in the community.
• Must be able to work independently as well as within a team environment, be flexible, highly organized and be able to prioritize their work.

• Use of software programs including but not limited to Excel, Word, and other computerized systems utilized for documenting activity and actions including but not limited to scanning and generating correspondence, Fallon CRM and QNXT.
• Must be able to prepare and manipulate spreadsheets (with or without pivot tables)
• Ability to handle multiple priorities and plan effectively.
• Independent learning skills and familiarity with various learning methodologies

• Exceptional customer service and collaboration skills

• Critical thinking skills for independent problem solving
• Attention to detail and accuracy of work output
• Attention to detail and the ability to document work processes clearly and accurately
• Ability to mentor and train others

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.