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Fallon Health Benefits/HRIS Analyst in Worcester, Massachusetts


About Fallon Health

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit

Brief Summary of Purpose:

Partners with HR staff and managers in assigned business area(s) on implementing, analyzing, and administering various benefit programs. Conducts analysis in support of overall benefit program design, planning, and administration. Responsible for system testing, development and process improvements within the HRIS.

Additional responsibilities include overseeing the day to day administration of benefit plans, ensuring compliance with regulatory requirements as well as timely and accurate service to participants. Interfaces with key benefit providers/vendors and provides information as needed.


Benefits and Leave Management

  • Manage employee needs and requests for information regarding retirement, health & welfare plans and other benefit plans

  • Provides training to management staff and human resources regarding regulatory compliance with ERISA, COBRA and FMLA as required. Provide advice to HR and management to ensure compliance.

  • Respond to Individual inquiries

  • Process requests and claim resolutions

  • Acts as resource to ensure optional usage of benefit plans

  • Assist in all open enrollment activities

  • Manage Family Medical, State Mandated Leave and Personal Leave cases and process with third party vendor

  • Manage workers compensation administration and process with carrier; including annual required reporting

  • Work with Management and third party vendor on ADA employee requests

  • Partner with management to explain benefit program policies and procedures and assist in complying with the same.

  • Participate in surveys to enhance competitive benefit offerings

  • Assist in retirement plan annual audit procedures including reporting and auditor relations

  • Administer the “Employee Tuition Reimbursement” program. Track employee reimbursement’s.

HR Systems Maintenance and Development

  • Assist in the review, testing and implementation of HRIS system upgrades or patches. Collaborate with functional and technical staff to coordinate application of upgrade or fix. Document process and results.

  • Assists with HRIS projects such as self-service implementation, system changes, and implementations, etc.

  • Provide support for HRIS including, but not limited to, researching and resolving HRIS problems, unexpected results or process flaws; perform scheduled activities; recommend solutions or alternate methods to meet requirements.Recommend process/customer service improvements, innovative solutions, policy changes and/or major variations from established policy that must be approved by appropriate leadership prior to implementation. Serve as a key liaison with third parties and other stakeholders (e.g. payroll). Use project management skills in managing projects. May provide overall project management for a given HR initiative.

  • Serves as resource for analytical and reporting help for other staff in support of assigned programs.

  • Work within multiple vendor programs

Benefit/HRIS Administration

  • Provide input to benefit program communications.

  • Partner with management to explain benefit program policies and procedures and assist in complying with the same.

  • Safety Committee Member

  • Work with vendor and employees on office ergonomic requests

  • Back-up HR Service

  • Performs other tasks and projects as assigned within the Benefit/HRIS Department.


  • Bachelor's Degree in related field or equivalent in education and experience.

  • 3-5 years of progressive and relevant HR experience in Benefits and HRIS in the areas of data maintenance and management, benefit administration, benefit communication, etc.

  • Proven experience in process/project management preferred

  • Proficient knowledge of Payroll/HRIS/Vendor Interfaces

  • Proficient knowledge of Excel

  • Knowledge of ERISA, IRS and DOL rules and other regulations pertaining to retirement and Health & Welfare Health Plans

Interpretation of Plan Documents

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.

Location US-MA-Worcester

Posted Date 2 months ago (3/16/2021 3:48 PM)

Job ID 6270

# Positions 1

Category Human Resources