About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
This unique position blends business project management tasks with complex data analysis and reporting skills to support Network Develop and Management’s contracting, strategic and operational goals in a fast paced business environment.
Primary Job Responsibilities:
Manages all aspects of NDM’s reporting, data extracts, and provider data quality resolutions for key provider partners in support of network management business through contract template modifications, report development, analysis, documentation, and distribution. This position will also require providing a level of analytic support for compliance requirements for federally funded programs and submission to state and federal agencies on a monthly, quarterly and annual basis.
Serves as the systems, data and reporting expert resource for NDM. Elicits, organizes and documents FCHP internal and external customer business requirements to ensure appropriate solutions are developed that support NDM’s and the provider community’s operational and strategic objectives. Participates in database development and quality teams and is expected to work with the user community, management and technical staff to identify, document, and resolve cross functional data quality issues.
Liaison to the end-user provider community, all NDM departments and technical developers with respect to data generation, reporting and quality.
Ensures the development, analysis and distribution of a variety of standard and customized reports and summary output based on specific contractual terms with various physician groups and hospitals that support FCHP’s provider community.
Develops or enhances data gathering and measurement tools for all NDM key operations and prepares dashboard reports for all NDM departments. Trains other NDM analysts or reporting staff to manipulate data variables and run reports at predetermined frequencies.
Quickly learns new business concepts and practices in order to develop a comprehensive understanding of customer issues to be resolved.
Exhibits thorough understanding of project management methodology. Plans and facilitates cross-functional team meetings as required. Participate in analyzing relevant business processes and exchanges of information within and across departments
Education: Bachelor’s degree in business, MIS or public healthcare preferred. Legal office experience a plus.