Job Description
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:
As a member of the Enterprise Project Management Office team, the Senior Business Analyst is responsible for the documentation of Business requirements at a Project/Program level, key user experiences, including member and provider journey, business process modeling, diagrams, & data flows and develops detailed current and future state analyses and downstream impacts reporting. This role is a critical function within the project management lifecycle and must have the ability to manage multiple deliverables effectively in a fast-paced environment. Many of systems rely on core business functions (ex. claims processing, provider contracting, network management) and a complex ecosystem, so a deep understanding of Fallon business processes, systems, business requirements, and data flow are critical for the long-term success to ensure we achieve desired project outcomes and deliver value to our internal and external business partners, members and providers.
Responsibilities:
Primary Job Responsibilities
Serve as the liaison between the Business and IT functions throughout the project life cycle, bridging the gap between business needs and technology solutions
Requires close coordination with Project/Program managers within the ePMO working directly under the guidance of Project/Program Manager
Facilitates process workshop sessions with subject-matter staff from the various business functions to elicit underlying business needs and concerns, further analyze and document the business process with the intent to define current and future state
Write clear and well-structured business requirements and end-to-end business process documentation
Utilization of project management methodology for scope definition and business requirements
Identify automation opportunities
Create process diagrams, workflows, dashboards and visualizations to help others understand business processes
Perform data discovery, analysis and modeling
Analyze process issues and bottlenecks to make improvements
Communicate and validate requirements with relevant stakeholders
Determine operational objectives by studying business functions, gathering information, and evaluating output requirements and formats
Construct workflow charts and diagrams, studying system capabilities, and writing specifications
Improve systems by studying current practices and designing modifications
Prepare reports by collecting, analyzing, and summarizing information and trends
Interpret, evaluate, and interrelate data to develop integrated business analyses and provide input for incorporation into strategic decision-making
Understand and communicate potential financial and operational impact of any changes
Suggest changes to management using analytics to support your recommendations. Actively participate in the implementation of approved changes
Create informative, actionable, and repeatable reporting that highlights relevant business trends and opportunities for improvement
Develop and maintain reporting tools
Conduct insightful, ad hoc analysis to investigate ongoing or one-time operational issues
Recognizes when changing customer or organizational expectations require new approaches and takes the necessary steps to meet new standards.
Work on multiple projects and assist with other departmental needs and initiatives, as needed
Qualifications:
Education:
Bachelor's Degree Required
License/Certification:
Relevant certification is a plus
Experience:
5 to 7 years of experience in business analysis within the healthcare industry
Experience with healthcare industry, software development, data, and systems
This role is inherently cross-functional, and you must be an effective communicator with both technical and non-technical stakeholders
Analytical thinking, active listening, problem solving and decision-making skills are critical strengths required for this role
Ability to comprehend and communicate complex information written and verbal in varied formats to internal and external customers
Ability to facilitate and lead cross-functional workgroup sessions
Establish and maintain positive and collaborative relationships with key internal and external partners, remove ambiguity and obstacles
Advanced skill set in business process modeling, process mapping, design, workflow diagrams
Demonstrated ability to understand and discuss technical and business concepts, manage tradeoffs, and evaluate opportunistic new ideas with internal and external partners
Project Management Body of Knowledge (PMBOK) is a plus
Experience with agile, safe, and/or waterfall methodologies
Advanced skills with Microsoft applications, such as Word, Excel, PowerPoint, Visio, Access and other applications i.e. Power BI, SAP Business Objects, etc.
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.
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Job Tags
Local area, Remote job, Flexible hours,