WorcesterRecruiter Since 2001
the smart solution for Worcester jobs

Analyst IV-Operation Support Services - Growing Healthcare Organization - REMOTE

Company: Fallon Health
Location: Worcester
Posted on: November 24, 2022

Job Description:


About Fallon Health:

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 delivers equitable, high-quality coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. 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 OSS Analyst IV 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.


Job Responsibilities:

Uses querying and programming skills to develop complex production and ad hoc reports using both small and large data sets

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

Prepares comprehensive data analysis using FCHP systems (including but not limited to, Enterprise data warehouse, Avenue QNXT replicated server)

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.

Works to improve data quality and collection process to meet diverse and changing needs for service improvement activities

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.

Performs, leads or assists in a variety of special projects as requested

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
Participant in cross functional initiatives including committee representation.
Responsible for up to 3 large projects per year that require extensive scoping, creative and innovative solutions and project management from scoping to final deliverable.


Bachelor Degree required, Master's Degree preferred




Proficient in T- SQL, Visual Basics, MS Visio and MS office including Access, Word, Excel & Power point.
Must have proven ability to perform advanced programming, program design and use of tables, queries, forms and macros.
Business analysis experience on at least 5 major enterprise projects.
Excellent interpersonal, verbal and written communications skills.
Ability to facilitate meetings and requirement sessions.
7+ years of analytic experience preferred and 5+ years of experience within the managed care industry preferred.

Resources used in performing role:

SSMS (SQL Server Management Studio), Crystal Reports (if applicable), Business Objects / Web Intelligence, MS Visio, MS Office, other applications

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.

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.


Keywords: Fallon Health, Worcester , Analyst IV-Operation Support Services - Growing Healthcare Organization - REMOTE, Healthcare , Worcester, Massachusetts

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Massachusetts jobs by following @recnetMA on Twitter!

Worcester RSS job feeds