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Fallon Health NaviCare Inside Sales Representative - Spanish Preferred in Worcester, Massachusetts


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.


  • 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 confidentialityMaintains 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, CMS and department policies and procedures.

  • Become an expert on Sharepoint CRM.



Bachelor’s degree or equivalent combination of education and experience

License/Certifications :

MA Health insurance license or ability to obtain license within 6 months of obtaining position

Annually, required to pass a product certification exam

Annually, required to take the AHIP certification


  • 3 years’ experience in sales or service environment

  • Previous experience coordinating sales activities and events as well as providing support in the field.

  • Strong knowledge of Microsoft Office products

  • Demonstrate strong customer service skills and willingness to “own” a prospect from start to finish

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.

Location US-MA-Worcester

Posted Date 4 days ago (4/6/2021 5:25 PM)

Job ID 6308

# Positions 1

Category Sales