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Fallon Health Sr. Reporting and Data Business Analyst - SQL - CMS & Medicare 5 STAR Rating! - Growing Healthcare Organization! 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 accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.

Brief Summary of Purpose:

Principle responsibility of the Operation Support Services Star Analyst IV is to collaborate with Fallon Health’s 5 Star owner to produce dashboards, trend and surveillance reports for senior management and department leaders and teams, tracking individual measure and interventions performance. Dashboard reports are based on real time cross sectional segments. This includes working with business areas to design, develop, modify and test reports to support business needs and transaction management in support of Fallon’s 5 star rating goals. 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 into manageable data segments with actionable activities.. 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.


  • Produce dashboards, trend and surveillance reports for senior management and department leaders and teams, tracking individual measure and interventions performance. Dashboard reports are based on real time cross sectional segments.

  • Analyzes and supports data analytics to easily identify Medicare Star measures for cultural trends (demographics, disparities and social determinants), operational inefficiencies and provider practice patterns

  • 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

  • Assist in the identification of trends that impacts 5 Star ratings

  • 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.

  • Actively participate in 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 skillsSupport design and execution of analytical roadmap in collaboration with organizational 5 star owner and domain experts to drive delivery of analytical projects that support relevant, actionable business insights.

  • Work collaboratively with Director and business owners

  • Provides assistance on technical matters and act as a significant information resource

  • Participant in cross functional initiatives


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

Proficient in T- SQL, VB, 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 analysis. Excellent interpersonal, verbal and written communications skills. Ability to facilitate meetings and requirement sessions. 3+ years of experience with CMS Star ratings a big plus! experience with quality or other comparable data reporting experience required.

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


Location US-MA-Worcester

Posted Date 2 weeks ago (1/12/2021 10:25 AM)

Job ID 6192

# Positions 1

Category Data Management/Reporting