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Fallon Health Outreach & Community Sales Specialist - Salary + incentives - Berkshire County in Berkshire, Massachusetts


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:

This position requires that the Account executive / Community Outreach sales role achieves personal referral and outreach goals for and the NaviCare program. Manages a territory and group of referral source accounts, providing regular follow up and overcoming barriers with each account to meet enrollment goals.


Job Responsibilities:

  • Relationship Building

  • Creates productive and collaborative relationships with internal and external referral sources in order to obtain qualified referrals and enrollments for the NaviCare program.

  • Participates in all community outreach activities, such as senior fairs, community events, and elder services professional association events to ensure Fallon Health’s visibility and presence in your territory.

  • Presents the NaviCare 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  • Shows accountability and follows up with prospects until the lead is closed/withdrawn and document as appropriate. Achieves monthly referral and home visit request goals

  • Secure Applications

  • Generates sufficient NaviCare enrollment applications to meet monthly enrollment goals.

  • Explains the NaviCare 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 NaviCare 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 NaviCare applications and documentation related to scope of appointments.

  • Assessment

  • Regularly reviews effectiveness of efforts against goals. Provides market intelligence to the NaviCare/ Manager and the Outreach Director so that adjustments can be made to tactical plans.

  • Manages their own professional development by seeking advice, training, and coaching from their colleagues, manager, and the Director of Outreach.

  • 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 NaviCare prospect events to Outreach Support in a timely manner, for CMS submission.

  • When in doubt, asks questions pertaining to compliance or privacy regulations.



BS or BA degree and/or comparable experience


  • AHIP (can obtain after hire)

  • Massachusetts Driver’s License


  • Knowledge and experience working with community organizations, low income communities and the elderly

  • 3 years of sales experience in healthcare or group insurance strongly preferred.

  • Must have proven experience working in a customer facing role focused on sales, lead generation in a high paced customer service or sales environment.

  • Knowledge of Medicare, Medicaid and insurance products is desirable.

  • Knowledge of customer service, sales, outreach and marketing principles and practices.

  • Possession of a valid Mass. driver’s license and a vehicle to be used for marketing activities and home visits.

About Fallon Health:

Fallon Health is a mission-driven not-for-profit health care services organization based in Worcester, Massachusetts. For 45 years we have been improving health and inspiring hope in the communities we serve. Committed to caring for those who need us most, we pride ourselves on providing equitable access to coordinated, integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of All-Inclusive Care for the Elderly (PACE). Dedicated to delivering high quality health care, we are continually rated among the nation’s top health plans for member experience and service and clinical quality.

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.

Fallon Health Vaccination Requirements:

To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022 all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Keywords : Community, outreach, senior care options, sales, elder services, masshealth, Berkshire county, Spanish, Portuguese


Location US-MA-Berkshire

Posted Date 1 month ago (8/24/2023 11:49 AM)

Job ID 7398

# Positions 1

Category Other