Fallon Health Data & Financial Reporting Analyst - New Career Growth Join Fallon Health! in Worcester, Massachusetts


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 the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit.

Brief summary of purpose:

The Financial Reporting and Planning Principal (FRPP) is a key strategic partner to management across the organization. The role requires demonstrated proficiency in the performance of budgeting, planning, accounting, reporting, financial modeling and analytics. The FRPP will support both corporate overhead and business segment management as Fallon Health continues to ensure the long term fiscal viability of its organization. In addition to the preparation of standard financial reports, the Principal will be required to prepare ad hoc management analysis and lead the process of developing budgets and forecasts as part of the strategic planning cycle. In order to ensure compliance with State and Federal statute, the FRPP will oversee / prepare all necessary regulatory reports and ensure support of those documents upon audit. The Principal will be the primary liaison to both internal and external auditors and is responsible to ensure the timely and accurate completion of all Fallon Health audits. The FRPP will develop policies and procedures that foster and maintain a strong control environment ensuring financial statements are free from material misstatement.

The Principal will employ specialized expertise in exercising their finance duties as they contribute to the execution and development of corporate strategy and objectives. They will use creative means to evaluate complex problems, gather and analyze relevant data and exercise independent judgement in the development of appropriate recommendations and solutions. The Principal has significant latitude in planning and executing their workload and will operate independently within a broadly defined set of corporate policies and practices. It is expected that the Principal will provide guidance that could have substantial impact on the Organization and its resources, therefore, they will need to successfully interact with management and senior personnel on matters requiring coordination across organizational lines. The successful candidate will have extensive expertise and will be a key contributor on a high performing reporting and analytics team.



  • Work seamlessly within the general ledger system to record / approve transactions in order to appropriately report the financial activity of the organization

  • Perform complex internal account reconciliations with a high degree of accuracy

  • Prepare a statement of financial position, a statement of operations and change in net assets as well as other complex financial management and Board documents associated with the monthly, quarterly and annual financial statement close process

  • Has 6+ years of experience and can independently understand GAAP concepts, practices and procedures

  • Has 6+ years of experience and can execute the implementation of State specific accounting concepts, practices and procedures necessary for regulatory reporting (STAT)Has 6+ years of experience and can demonstrate a full understanding of consolidation accounting concepts, practices and procedures

  • Has 6+ years of experience and can demonstrate a full understanding of consolidation accounting concepts, practices and procedures

  • Extract data from internal and external systems and fully analyze financial results – is comfortable creating, modifying and executing data scripts and queries in order to ensure appropriate support for key financial figures

  • Report financial results to management and offer strategic insight relative to revenue maximization, cost containment (medical and SG&A) and general resource consumption

  • Develop and present actionable recommendations and solutions to management that will impact key results

  • Collaboratively partner with business segment owners and corporate executives to quantify the resources required to achieve strategic initiatives and capital investment goals during budget and forecast cycles

  • Evaluate trends, costs, revenues, financial commitments and obligations incurred to predict and model future revenues and expenses

  • Analyze results and evaluate against underlying assumptions used to forecast and budget performance

  • Design and populate financial models that will assist management in strategic decision making

  • Has 6+ years of experience and can demonstrate a full understanding of specific business models and practices

  • Has 6+ years and can demonstrate the ability to develop integrated revenue / expense analysis, projections, reports and presentations

  • Has 6+ years of experience and can demonstrate proficiency in financial forecasting and budgeting

  • Prepare, analyze and file cost reports and settlements as necessary to ensure compliance with State and Federal regulations

  • Research new accounting pronouncements and emerging guidance – make recommendations regarding company policy and practice

  • The primary liaison for both internal and external audit processes – ensure timely coordination and the delivery of all requirements, review financial statements to ensure they are free of material misstatement, aggregate and/or prepare appropriate supporting documentation, create required footnote disclosures and maintain an environment of strong internal controls



  • Bachelor’s degree in accounting or finance (other relevant majors will be considered)

License / Certifications:

  • MBA / CPA preferred but not required, relevant experience will be considered

Demonstrated proficiency in performing budgeting, planning, accounting, reporting, financial modeling, and analytic assignments

  • At least 6+ years of experience in a managed care environment (will consider other relevant health care, social service, insurance or not-for-profit experience)

  • Experienced user of software applications necessary to achieve job requirements (ex. Oracle, Adaptive Insights, Business Objects, etc.)

  • Microsoft Office super-user

Strong knowledge of the following:

  • Medicare, Medicaid (ACO / MCO) and other government programs

  • Commercial and ASO Insurance programs

  • TPA services

  • Tax preparation / filing requirements

  • ACA reporting and expense requirements

  • GAAP and STAT reporting requirements

  • Rolling forecast and budget practices

  • Consolidation accounting and advanced accounting concepts

Working knowledge of the following:

  • Actuarial concepts such as IBNR claims and PDR

  • Risk adjustment and encounter data

  • ORSA and enterprise risk management practices

Job ID 5452

# Positions 1

Category Finance