Senior Encounter Data Analyst & Risk Adjustment Lead

Fallon Health; Massachusetts; On-site; USD 125,000 - 130,000; Full time

Job summary

Fallon Health in Worcester, MA seeks an Information Management Analyst III to lead analysis, validation, reconciliation, and submission of healthcare encounter data to the Commonwealth of Massachusetts and other regulators.

The role acts as the subject matter expert in encounter reporting, partners with Risk Adjustment and cross-functional teams to ensure data accuracy, compliance, and quality reporting, and mentors junior analysts as part of succession planning.

Qualifications

• Bachelor’s degree in CS/IS or related field required; other degrees considered with relevant experience.
• 5+ years in healthcare data analytics, encounter or regulatory reporting.
• Strong SQL, data warehousing, analytics, and data visualization skills.

Responsibilities

• Monitor encounter submission performance, rejections, and acceptance rates.
• Analyze and resolve encounter data errors and submission failures.
• Ensure compliance with MA reporting requirements and deadlines.
• Coordinate testing for system changes affecting encounter data.
• Collaborate with Risk Adjustment to improve data accuracy.
• Lead special projects and mentor junior analysts.

Skills

SQL

Data analytics

Data warehousing

Visualization

Project management

Requirements elicitation

Education

Bachelors in CS / MIS / related field

Job description

Fallon Health in Worcester, MA seeks an Information Management Analyst III to lead analysis, validation, reconciliation, and submission of healthcare encounter data to the Commonwealth of Massachusetts and other regulators.

The role acts as the subject matter expert in encounter reporting, partners with Risk Adjustment and cross-functional teams to ensure data accuracy, compliance, and quality reporting, and mentors junior analysts as part of succession planning.