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Fallon Health

Not-for-profit health plan for seniors.

Business Systems Analyst 3

Full-TimePosted on 10/6/2026Deadline 10/6/27
No salary listed
Senior, Expert
Bachelor's
Worcester, MA, USA
In Person
Business & StrategyBusiness Analysis

About the job

Requirements
  • A bachelor's degree or equivalent experience is preferred.
  • Requires 5 to 10 years of business analysis experience, including writing SMART requirements, managing scope, elicitation skills, and process mapping, or equivalent experience.
  • Five or more years of experience writing technical specifications, or equivalent experience.
  • Five or more years of experience in data analysis in an information technology operating environment, or equivalent experience.
  • Excellent understanding of relational concepts and their business applicability in healthcare management.
  • Intermediate knowledge of SQL and relational technology, with proficient query-writing experience, or equivalent experience.
  • Two years of healthcare industry experience is required.
Responsibilities
  • Analyze high-level project scope for impact and feasibility within defined time and cost constraints with minimal direction, and assist in preparing project scoping documents.
  • Determine the appropriate approach to the business analysis effort and define required project-specific outcomes and deliverables.
  • Elicit customers' and stakeholders' underlying business needs and concerns using standard methods, including interviews and desired-state process workflows.
  • Facilitate and document requirements-gathering sessions with small groups of business representatives and subject matter experts.
  • Manage conflicts and competing demands, escalating difficult issues to the Project Manager, direct manager, or more senior colleagues for resolution.
  • Use business acumen to formulate probing questions and shape effective solutions to difficult problems, including those with potential milestone implications.
  • Clearly document business requirements in sufficient detail for customer sign-off and completion of the Technical Design Document.
  • Develop comprehensive use cases to support solution development and validate them with the customer.
  • Collaborate with the Development Team to identify data requirements and mappings, establish practical and efficient design and testing approaches, and provide suggestions and feedback.
  • Collaborate with the Design and Development Team during technical design, programming, and initial testing; work with the business to develop a high-level test plan based on documented requirements; create comprehensive test plans and queries; document test results; validate outputs against business requirements; identify defects; assess defect effort with the Development Team; and work with the project team to prioritize and resolve defects.
  • Create user and training guides and conduct training and information sessions for user groups as needed.
Desired Qualifications
  • A bachelor's degree or equivalent experience is preferred.

About the company

Fallon Health is a not-for-profit health care organization that provides coordinated, integrated care for older adults and people with complex health needs. It offers Medicare Advantage, SCO, MassHealth ACO Partnership Plans, and Programs of All-Inclusive Care for the Elderly (PACE) in Massachusetts and New York, including Summit ElderCare and Fallon Health Weinberg–PACE. Its PACE programs deliver all-inclusive medical and social services as an alternative to nursing homes, funded through a mix of Medicare, Medicaid, and private coverage. The company differentiates itself by a not-for-profit mission, strong community engagement, and a focus on vulnerable populations, with top ratings for member experience and clinical quality; its goal is to improve health and quality of life while promoting equitable care.

Company Size

501-1,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Worcester, Massachusetts

Founded

1977

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Simplify's Take

What believers are saying

  • Fallon launched Southeastern Massachusetts PACE access in November 2025, expanding eldercare demand.
  • WooSox extended Fallon's partnership through 2028, reinforcing local brand visibility.
  • NCQA's 5-star Medicaid rating and Press Ganey recognition strengthen retention with Massachusetts buyers.

What critics are saying

  • Mass General Brigham's January 8, 2026 takeover statement signals Fallon loses independence.
  • Zelis replaced PaySpan in September 2026, creating provider-payment migration risk.
  • One-third of 2026 provider updates fix billing errors and authorization changes, showing operational friction.

What makes Fallon Health unique

  • Fallon Health earned NCQA's highest Medicaid rating in September 2026.
  • Its Massachusetts focus spans Medicare, Medicaid, PACE, and ACO products.
  • Mass General Brigham chose Fallon in January 2026 for a long-term health-plan combination.

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Benefits

  • Health Insurance
  • Paid Time Off
  • Paid Holidays
  • Vision Insurance
  • Life Insurance
  • Flexible Work Hours

Company News

Fallon Community Health Plan
Mar 3rd, 2022
Fallon Community Health Plan, Inc. hired Katie Acker as Health Equity Program Manager on Mar 3rd 22'.

Fallon Health, a nationally recognized not-for-profit health care services organization, today announced that Katie Acker, MPH, has been named to the newly created role of Health Equity Program Manager.

Worcester Business Journal
Feb 17th, 2022
Fallon Community Health Plan, Inc. hires Matthew Herndon as senior vice president and chief state programs officer

Worcester insurer Fallon Health has named Matthew Herndon to the newly created position of senior vice president and chief state programs officer.

Fallon Community Health Plan
Jan 11th, 2022
Fallon Community Health Plan, Inc. partnered with Worcesterschools on Jan 11th 22'.

It is with great pride that Fallon Community Health Plan, Inc. partner with the City of Worcester to provide five years of fitness at the Senior Center.”

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