Overview:

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.

Brief Summary of Purpose:

Responsible for operations to support the Medicare sales division, inclusive of sales force automation application, Medicare advantage, Medicare Supplement, eHealth, online quoting, Ultra Benefits core system and FCHP’s core system QNXT. Provide sales support and optimization of member retention in the Medicare segment. Assist with metrics to support new profitable growth. Work with staff to ensure that all sales operations processes are streamlined and that there are appropriate quality checks to hold team accountable for their work to support all other operations for FCHP. Represent sales to discuss impact of new products, changes to broker commission schedules, quarterly rate filings, new sales and renewal processes for both self-funded and fully insured Medicare products. Working with communications to ensure that all collateral and information is up to date and accurate. Provide data and reporting support that assist in the growth and retention FCHP membership.

Responsibilities:

Job Responsibilities:

Manage strategic partnerships
- Lead initiatives to support new products
- Identify and create new resources for strategic partners, including reporting, on-line tools, etc.
- Identify additional means to educate partners to enhance product knowledge and grow and retain business
- Develops and maintains new contacts and partnerships in the community.
Data management, analysis, and reporting
- Provide analytical and project management to the Medicare Sales team on a variety of initiatives that contriubte to the overall sales efforts to grow and retain members.
- Document, monitor and improve current business processes.
- Establish frequency for reporting to drive performance accountability for Medicare Sales.
- Develop reports to measure success of new sales and renewal processing against set metrics and standards.
- Manage the commission payment structure and reporting.
- Research and resolve questions raised by affiliated brokers regarding bonus and commission plans
- Assist Sales Coordinators and Sales Executives with broker related quoting activity
Monitors compliance
- Provide leadership and guidance to ensure compliant and appropriate management of sales channel.
- Ensure that Medicare sales representatives are in full compliance with state and federal regulatory requirements.
- Complete audits with all Medicare sales reps to monitor product knowledge and ensure their compliance with all Medicare regulations.
Manage Information Center
- Oversee Information Center team including defining roles and accountabilities for staff and manages the facilities and budget
- Develop strategic process to support division goals
- Define performance expectations and goals for staff
- Manages information center sales team to achieve annual enrollment goals.
- Train and mentor staff on the application of policy and procedures, use of supporting systems/applications, etc.
- Monitor work of staff for efficiency, effectiveness and quality. Provide ongoingEvaluate staff on achievement of goals and deliverables and assessment of competencies. Manage the resolution of performance issues in consultation with Human Resources as appropriate feedback and guidance to staff.
- Evaluate staff on achievement of goals and deliverables and assessment of competencies. Manage the resolution of performance issues in consultation with Human Resources as appropriate.

Qualifications:

Education:

Bachelor’s required or equivalent experience

License/Certification:

MA Health Producer
Valid Driver’s License and Clean Driving Record Required

Experience:

7-10 years’ experience in operations, performance management, marketing, communications, sales or related field

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.

JT18

Fallon Health

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Manager, Medicare Sales Operations