Inside Sales Representative

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

This role will set sales appointments, recruit attendance at group sales meetings, respond to benefit inquiries and complete enrollment applications for Mass General Brigham Health Plan’s Medicare prospects.

Principal Duties and Responsibilities:

• Serves as the resolution point for our Medicare Advantage members.
• Maintains all inventories and aging at or ahead of service level standards.
• Meets or exceeds productivity and quality standards for his/her team.
• Address prospect questions, including eligibility, benefit interpretation and cost sharing via inbound and outbound calls, walk-in contact and written correspondence/email.
• Assure understanding level of each prospect/enrollee by providing clear, complete and accurate information regarding assigned product benefits, policies and procedures.
• Qualify each prospect according to departmental and federal guidelines.
• Meet accessibility and quality goals, such as average speed of answer and abandonment rate. Document complete and accurate prospect records and process all appointments, registrations and requests for information in CRM.
• Meet individual and team membership goals.
• Follow company and federal sales and marketing guidelines in all interactions with prospects.
• Performs other duties as assigned.

• Research issues delegated to them from other departments within Mass General Brigham Health Plan as well as vendors
• Resolves complex benefits, claims and eligibility issues

o Identifies prospective member issues/concerns rapidly and precisely
o Research required information using available resources and triage when necessary
o Handles and resolves prospective member inquiries and complaints.
o Initiates follow up prospective member calls
o Completes call logs to record prospective member interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
o Refers prospective member grievances and appeals to designated departments for further investigation
o Responsible for navigating multiple systems in order to resolve prospective member issues

• Receives and responds via email to inquiries from members and providers.

o Research prospective memberconcerns and take accountability through resolution
o Escalate prospective member complaints and feedback to management as required
o Achieve and maintain departmental productivity
o Completes call logs to record prospective member interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
o Responsible for navigating multiple systems in order to resolve prospective member issues

• Serves as a liaison between Prospective member Service and various departments and vendors within the organization.
• Provides feedback to leadership on trends
• Answers inbound ACD calls during periods of high call volume
• Returns after hours Voicemail Messages
• Handles incoming post mail and faxes.
• Acts as the primary representative for Mass General Brigham Health Plan for our prospective member focusing on engagement.
• Anticipates and meets, or exceeds, internal and/or external prospective member expectations and requirements; establishes and maintains effective relationships with prospective member and gains their trust and respect.
• Maintain Prospective member Service Behavior Competencies

o Communication
o Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude
o Relationship Building/Caring
o Service Excellence/Accountability/Critical Thinking

• Hold self and others accountable to meet commitments.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

Skills/Abilities/Competencies:

• Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value.
• Bring fresh ideas forward by listening to and working with employees and the people we serve.
• Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner.
• Strong, demonstrated track record of an ability to execute on time, on budget, and on scope.
• Strong aptitude for technology-based solutions.
• Ability to inject energy, when and where it’s needed.
• Current in healthcare trends.
• Demonstrated forward, visionary thinking; ability to see “what is” and envision “what could be.”
• Ability to develop, introduce, defend, and gain support for a new ideas and approaches.
• Excellent leadership skills and leadership track record.
• Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required.
• Ability to view the long-range trends and cycles of the business and industry and see the “big picture.”
• Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.
• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.
• Excellent interpersonal skills, including the ability to influence others at all levels of an organization.
• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
• Unquestionable integrity.

Supervisory Responsibilities:

• Inform, engage, inspire, motivate, and actively listen to employees.
• Make decisions that put the needs of the people we serve—our members, providers, brokers, and employers—front and center.
• Communicate and cascade information to employees in a timely manner and actively participate in the success of cross-organizational programs and initiatives.
• Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations.
• Hire, participate in, and/or recommend development measures and disciplinary actions up to and including termination; evaluate performance and supervise the work of all direct and indirect reports following established organizational policies, procedures, and practices.
• Set clear goals and objectives, use metrics to measure performance, and hold employees accountable. Provide coaching to improve performance and holds regular development meetings.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.

Fiscal Responsibility:

• No direct budgetary responsibility
• Demonstrates fiscal responsibility by effectively using Mass General Brigham Health Plan resources

Working Conditions:

• Normal office working conditions.
• Remote, Hybrid or onsite