Business Systems Analyst-ll - 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  or follow us on Facebook, Twitter and Linked In.

This position requires permanent work authorization in the U.S. We will not provide visa sponsorship or accept candidates on OPT/CPT for this role.

• 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 Dev Ops, or Alteryx.
• Experience supporting enterprise applications and data-driven decision making.

• 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.

Education :
Bachelor Degree equivalent experience preferred.

• Requires 3+…