Medical Economics Data Analyst

Overview

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 Medical Economics Data Analyst will partner with Medical Economics team members in assistance of data and reporting automation and package development, to support internal product line owners, as well as external provider partners.  This role will be responsible for engaging with other analysts within the Finance Division and business users to ensure data quality and data integrity for reporting and analytical activities.  

Responsibilities

Primary Job Responsibilities

• Prepare standard reports and analyses relating to membership reporting and monitoring of cost and utilization trends for internal and external audiences.  Ensure that all reporting and analyses are accurate, reliable and completed within specified timelines. 
• Identify opportunities for improving efficiency and automation of standard reporting packages.  Works to improve data quality, collection processes and report design to meet diverse and changing needs for reporting.
• Collaborate on the design, development and validation of new reports.  Monitor and maintain updates to process documents.
• Coordinate across teams within Finance to support provider risk settlements and reporting.
• Provide technical and analytical support for multiple regulatory filings.
• Assist other Medical Economics team members on special projects or ad hoc requests.

Qualifications

Education:

Bachelor’s degree in Business, Finance, Math, Economics or Public Health

Experience:

• Minimum of 1 - 2 years in healthcare environment
• Experience with data analysis and reporting of clinical and financial data
• Experience with Microsoft Excel, ACCESS, SSMS or SQL
• Knowledge of managed care and health care claims
• Excellent oral and written communication skills

COVID-19 Vaccination:

With the end of the Global Coronavirus COVID-19 Pandemic, Fallon Health no longer requires all employees to be vaccinated against COVID-19 except for employees who are in jobs that under state and federal laws, regulations and policies are required to be vaccinated and/or they are in Member/participant facing positions.

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.