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:

The Business Systems Analyst III works on initiatives of complex scope and is responsible for defining scope and objectives; eliciting, analyzing, and documenting SMART functional and non-functional business requirements; documenting current-state and future-state workflows; developing data/file mappings and technical specifications; and partnering with stakeholders to prioritize requirements. The role collaborates with Project Managers on work estimates, deliverable and task breakdowns, risk management, and project-plan updates. The BSA III assesses system capabilities and interdependencies, collaborates with design and development teams, provides technical guidance, and identifies alternative solutions that balance business and technical needs.

Primary Job Responsibilities:

• Analyze proposed initiatives and provide high-level scope, impact, feasibility, dependencies, and delivery considerations within established time and cost constraints, with minimal direction.
• Determine the appropriate business analysis approach, required outcomes, and deliverables based on initiative complexity, stakeholder needs, and project objectives.
• Elicit underlying business needs and concerns through interviews, facilitated sessions, process analysis, and current-state and future-state workflow development.
• Facilitate and document requirements sessions with business representatives and subject matter experts; manage conflicts and competing priorities and escalate complex issues when needed.
• Define and document clear, testable SMART functional and non-functional requirements with sufficient detail to support stakeholder review, approval, technical design, development, and traceability.
• Partner with business stakeholders to define scope and objectives, prioritize requirements, and obtain documented agreement or sign-off.
• Develop and validate comprehensive use cases, process flows, acceptance criteria, and supporting analysis artifacts.
• Work as part of the IT team supporting Fallon Health’s Population Health platform and related business capabilities.
• Collaborate with Project Managers to estimate work, break down deliverables and tasks, identify and manage risks and dependencies, and provide updates for project planning.
• Collaborate with design and development teams to identify data requirements and mappings, evaluate system capabilities and interdependencies, and establish practical design and testing approaches.
• Participate throughout technical design, development, and initial testing; provide complex technical guidance, suggestions, and feedback while maintaining alignment with approved business requirements.
• Collaborate with the business to develop high-level testing plans; create detailed test plans, test scenarios, queries, and evidence; validate results against requirements; identify defects; and support defect prioritization and resolution.
• Prepare user guides and training materials and conduct training or information sessions as needed.
• Mentor less-experienced team members and contribute to team standards, process improvements, workgroups, and knowledge sharing.

Core Competencies and Performance Expectations 

• Advanced analytical, problem-solving, conceptual-thinking, and business-acumen skills. 
• Excellent interpersonal, verbal, and written communication, including effective meeting and requirements-session facilitation. 
• Ability to prioritize, organize, follow up, and meet critical deadlines across competing demands. 
• Open communication, adaptability, initiative, sound judgment, and a continuous-improvement mindset. 
• Ability to work independently while escalating complex issues appropriately

Education:

• Bachelor Degree equivalent experience preferred

• Care Services background a PLUS
• Population Health application experience a PLUS

Experience:

5–10 years of business analysis, SMART requirements documentation, scope management, elicitation, process mapping, and related experience, or equivalent experience. SQL / Query writing preferred. Experience applying database concepts in healthcare management. Prior health plan operations experience preferred.

Pay Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 128,000 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.

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.