Business Systems Analyst-ll - Growing Healthcare Organization

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.

• MA, CT, RI, NH, NY (not Burroughs )

Fallon Health is seeking a Business Systems Analyst II to bridge business operations, technology solutions, and enterprise data. This role combines traditional business analysis with hands-on data analysis to support healthcare business processes, system enhancements, production support, and strategic initiatives.

The ideal candidate is equally comfortable facilitating requirements discussions with business stakeholders and writing SQL queries to investigate issues, validate business rules, and analyze data. Strong SQL and analytical skills are essential. This role needs to be competent in healthcare, QNXT platform (preferred), requirements analysis, and SQL-based validation.

• →Partner with business and technology teams to gather and document requirements.
• →Analyze business processes, workflows, integrations, and system impacts.
• →Write SQL queries to validate data, investigate issues, and support testing.
• →Perform data analysis, reconciliation, and root cause investigations.
• →Translate business needs into requirements, user stories, process flows, and data mappings.
• →Support solution design, testing, implementation, and production support activities.
• →Identify process improvement and automation opportunities.

• Bachelor's degree or equivalent experience.
• 3+ years of Business Analyst, Systems Analyst, or Data Analyst experience.
• Strong SQL query writing skills including joins, aggregations, subqueries, and data validation techniques.
• Experience analyzing data in relational databases.
• Experience gathering requirements and documenting business processes.
• Strong analytical, problem-solving, and communication skills.

• Healthcare payer experience.
• Experience with claims, membership, provider, finance, or eligibility data.
• Familiarity with QNXT, SQL Server, Power BI, Azure DevOps, or Alteryx.
• Experience supporting enterprise applications and data-driven decision making.

• Ability to prioritize, organize and follow-up in order to meet critical deadlines
• Actively contributes to team discussions, workgroups and meetings.
• Ability to suggest ways to improve process, takes initiative.
• Good interpersonal, verbal, and written communication skills, ability to facilitate meetings.
• Moderate conceptual and analytical skills and business acumen.

Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 115,000-$120,000 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.

• Uses data to validate assumptions and business requirements.
• Independently investigates production and data issues.
• Understands how business processes connect to underlying data.
• Communicates effectively with both business and technical stakeholders.
• Balances analytical thinking with practical solution delivery.

• Requires 3+ years of business analysis, process mapping, etc. or equivalent experience
• 3+ year experience writing technical specifications or equivalent experience.
• 3+ year experience in data analysis in an information technology operating environment or equivalent experience.
• Strong understanding of data warehousing concepts, relational databases and business applicability in healthcare management.
• Basic knowledge of SQL and Relational technology and proficient query writing experience or equivalent experience.
• One year Healthcare Industry experience required.