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Sales Manager Health Insurance

Location:
Branford Center, CT, 06405
Posted:
September 26, 2023

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Resume:

Bill DeFrancesco

*** **** ******* ****, ******** CT

518-***-**** adzy1e@r.postjobfree.com

Senior healthcare sales leadership across health insurance pharmacy benefits management and pharmaceuticals, Innovative track record of incentive design, broker bonus creation, teambuilding, motivation, product launches and growth strategies. Technical depth and functional breadth

Executive Leadership • Health Insurance • Pharmacy Benefits Management (PBM) • Pharmaceutical Sales & Business Development • Self-Funded Insurance • Student Health Plans • Health Funding Arrangements • Union & Taft Hartley Sales • Multiple Specialty Physician Groups • Hospital Sales • Enhanced Primary Care • Specialty Markets Government • Medicaid & Medicare

HEALTH INSURANCE & PHARMACY BENEFITS MANAGER EXPERIENCE JULY 2010 – PRESENT

AmwinsRx / Shelton, CT April 2022 – Present

Vice President of Sales

Responsible for defining strategy and tactics for Pharmaceutical Benefits Management (PBM) sales and pharmaceutical cost containment execution. Developed various distribution models and marketing materials to meet and exceed revenue growth goals and objectives. Creative, strategic business planning that translates to external and internal actionable results.

●Mapped, defined and met with key business leaders and drivers.

●Forged internal Amwins relationships with all divisions that interact with Brokers, Third Party Administrators and Stop-loss carriers to take advantage of domestic opportunities.

oOngoing Live and Zoom calls with all Amwins line of business leaders

oLeveraged broker and vendor relationships from carrier and pharmaceutical industries

oCreated and facilitated corporate wide sales round tables

●Expanded revenue model to include Cost Containment practices and Patient Assistance Programs (PAP)

●Implemented new RFP tool as well as recreating all SME materials to be more focused on new business strategy

●Instrumental in negotiating new prescription contracting and pricing

●Creating a formalized implementation process and plan for new clients and members

●Organized and facilitated industry conference strategy and coverage

●Successfully built and leveraged relationships with Brokers, Third Party Administrators, Stop-loss carriers and other PBM’s to exceed revenue goals

Tufts Health Plan / Watertown, MA August 2017 – July 2021

Director of Commercial Sales, Large and Small Group New Sales

Responsible for driving all health insurance sales for large and small groups in Massachusetts and New Hampshire markets. Developed and implemented sales strategies to transform the organization to a more sales/customer focused environment

●Designed an investment strategy to focus on increasing Large Group CRC membership and Profit & Loss ratio for this target market

oNegotiated with Underwriting as to criteria that would warrant investment on specific employer groups

oEstablished a broker specific development and business plan

Increased outbound call activity 52%

Increased pipeline by 29%

Increased first time quotes by 41%

oSold an additional 20% or 12 CRC cases

●Worked with PEO’s and intermediaries on product development and sales training

●Created and executed on a banking focused vertical strategy resulting in

oAcquired 16 new Banks, Credit Unions and Savings & Trusts

oRepresenting over 3,877 new members & $38 million in premium

●Built Standard Industry Code and broker book of business Medical Loss Ratios (MLR’s) guide to affect Underwriting ratings

oIncreased sales with top tier brokers by 36%

oImproved first year medical loss ratios to below 88%

●Facilitated small group process improvement for end to end efficiencies and membership growth

oRecommended and implemented New CRM

oIncreased Sales Operations Team

oWorked with Product Development Team to create small group products in Massachusetts and New Hampshire

oGrew Small Group New Sales by 44% and $79 million as compared to previous 3 years of membership

●Created Sales and Broker Incentive/Compensation programs

●Identified as a key individual in the Tufts Health Plan & Harvard Pilgrim Health Plan’s combination

oServed as an expert in interviews by New Hampshire and Massachusetts Attorney General offices and the Department of Justice on market strategies, viability and market impact of the combined organization

oDesignated as an influencer to market activity by United Health Plan in its purchase of Tufts Health Freedom Plan

●Key roles in both Broker and Sales Engagement Steering Teams for the merged entity

Capital District Physicians Health Plan / Albany, NY August 2010 – July 2017

Director of Large Group New Sales

Responsible for driving health insurance sales for experienced rated large groups of employees and labor funds. Planned and executed the successful entrance into several new markets including Student Health Plans, Labor funds, and Self-funded clients.

●Increased large group new sales by over 307% or 64,000 members since taking over sales leadership compared to slightly over 13,500 members for the 6 years prior to arriving

●Exceeded sales goals every year despite market changes associated with the Affordable Care Act.

●Improved the number of large groups sold by 203%—181 large group

●Created and executed a successful Student Health Insurance Program (SHIP) strategy.

oCoordinated internal and external support from the matrix organization and external channels.

Brokers

Underwriting

Legal

Marketing

Compliance

Finance

Medical/Pharmacy

IT

Operations

Sales

oSold 18 Colleges and Universities both fully insured and self-funded (SHIP) representing over 15,000 students

●Instrumental in expanding the facilitation into different/new market segments

oSelf-funding options

oGroup Medicare

oLabor/Union sales

oDomestic/Narrow network options

●Orchestrated data transparency and integrity for sale representatives to internally compete

●Influential in the success of the Shared Health Funding Vehicle and marketing CDPHP’s Health Value Strategy

oElected by the CEO to the Shared Health Steering Committee

oNominated by the VP of Innovation to the product innovation team

●Designated by CMO to the data analytics team for transparency project

●Instituted an advanced training model that focuses on improvement of the team’s key performance indicators (KPI’s), by utilizing videotaped role plays, subject matter testing, and playbook style business planning

PHARMACEUTICAL EXPERIENCE 1991 - 2010

Meda AB Pharmaceuticals / Meda US Northeast February 2007 – January 2010

North Specialty Area Sales Manager--Promoted (August 2008-January 2010)

New York State Area Sales Manager (February 2007-August 2008)

Major Accomplishments:

●National Award Winner (3 times)

●Top 10% National Sales Performance Ranking - 2 Product Launches (2007,2008)

●Promoted & developed six (6) team members to Training or Advanced Sales positions

●Nationally ranked top 25% in both sales volume and market share (2008,2009)

●Business Analytics Rotation – identified best strategy to link Incentive Compensation to Field Sales motivation

●Mentor for two (2) District Sales Managers

Pfizer Inc. November 1991 - February 2007

Neuroscience District Sales Manager/Promoted (September 2005-February 2007)

District Manager/Promoted - Parke-Davis Division (January 2001-September 2005)

District Manager/Promoted – Northeast Specialty Division (September 1998-December 2000)

Specialty Representative Promoted (1994-1998) Professional Healthcare Representative (1991-1994)

Major Accomplishments:

●National Award Winner (16 times)

●Achieved 100% of total quota (1992 – 2006)

●Promoted 15 representatives during tenure

●Hired 4 Rookie of the Year recipients

●Hired, trained, and led #1 Allergy & Pediatric Sales organizations in National Sales Network

●Elected as State Government Relations Liaison (appointed by Vice President)

●Developed & leveraged executive level relationships internally

●Forged strategic partnerships with key thought & opinion leaders

●Facilitated District & Regional Marketing Teams’ Advisory Board

MARKETING & ADVERTISING EXPERIENCE February 2010 – June 2010

Wishbone Itp Advertising Agency, New York NY February 2010-June 2010

Account Executive & Market Specialist, Client: Meda Pharmaceuticals, Azelastine Brand Team

BUSINESS TO BUSINESS EXPERIENCE 1989 - 1991

IBM/Centra Software Group/System Sales September 1990 - November 1991

Pansophic Systems/Sales Associate June 1989 - September 1990

EDUCATION & ATHLETICS

Princeton University June 1989

Bachelor of Arts - History

NCAA Football Athlete

4 Year Varsity Football Player – Defensive Back



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