Sr. Business Analyst- Healthcare Operations - Remote

Overview

About us:

Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

Principal responsibility of the Operations Support Service Analyst IV (Senior Business Analyst) is to collaborate with business areas to design, develop, modify and test reports to support business needs and transaction management. The analyst will leverage their developer skill set and experience with large health care data sets and relational databases to develop complex reporting solutions. The objective of the Analyst IV activities is to attain efficiencies and effectiveness when capturing work outputs and transactional history. It is also expected that this analyst proactively identifies and addresses scalability and performance bottlenecks to support efficiencies. They are consultative to the business and accountable for the quality and effectiveness of the data in the subject area across all related systems (QNXT, data warehouse) and are expected to be subject matter experts for this data.

Responsibilities

• Consults, designs and produces health care information, business analysis, market analysis, geo analysis, survey analysis and reports to help support senior leadership and organizational priorities in addition to external reporting entities such as the Division of Insurance, NCQA, CMS, etc.. Responsible for both production and adhoc reporting.

• Reviews current reports and outputs for accuracy, efficiency, and viability

• Gathers business requirements; determines most effective and efficient reporting platform.

• Review logic, criteria, and definitions to incorporate into data models to extract functional data sets for reporting.

• Develops outputs based on gathered requirements.

• Proficiency in report development and analysis.

• Performs testing and re-engineering.

• Develops alternative techniques for gathering a variety of data that is not available from established sources.

• Assist in the identification of trends that impacts operational areas.

• Leverages mathematical calculations to determine integrity of data samples.

• Evaluates risks; collects statistical information to determine whether business areas have negative impacts on their businesses, or at least improve their business practices,

• Consultative to business owners to applying analytical findings to the business.

• Actively participate in analyst and committee meetings

• Identifies improvements regarding report efficiencies and platform effectiveness.

• Works with business owners to research root cause and communicate improvement recommendations.

• Participates in continuing education activities to improve upon skills.

• Develops presentations that are timely and concise; materials are accurate and up to date.

• Independently consults with data users, develops programs and analysis, and runs reports as well as presents findings. Responsible for independently producing important internal and external reports to regulators and customers.

• Responsible for identifying data quality issues. Accountable for results

• Provides assistance on technical matters and act as a significant information resource.

• Participate in cross functional initiatives including committee representation.

• Responsible for up to 3 large projects per year that requir