Fallon Health

Analyst IV-Operation Support Services

Location US-MA-Worcester
Posted Date 1 month ago(10/27/2020 9:41 PM)
Job ID
# Positions
Data Management/Reporting


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 fallonhealth.org.

About Summit ElderCare:

Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.

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.


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

  • 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
  • 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, 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 analyst 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

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

  • Work collaboratively with Manager and business owners
  • Provides assistance on technical matters and act as a significant information resource
  • Participant in cross functional initiatives
  • Reports will be requested across the enterprise



Bachelor Degree or advanced education preferably in Business Administration or Computer Science



5+ years’ experience in managed care industry is required.

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. 5+ years’ experience in data integrity analysis. Excellent interpersonal, verbal and written communications skills. Ability to facilitate meetings and requirement sessions.


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.




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