Epic Tapestry Utilization Management
$176,800–$176,800 year
RemoteBoston, Massachusetts, United States
Job Summary
Design, configure, and maintain Epic Tapestry Utilization Management workflows, including prior authorization, referral, and service authorization functionality. Build work queues, routing rules, decision trees, and SmartTools while collaborating with operational leaders to develop future-state processes. Partner with clinical reviewers, care management, and claims teams to optimize end-to-end UM processes and ensure compliance with CMS, NCQA, HIPAA, and state regulatory requirements. Perform system testing, troubleshoot application issues, and support Epic upgrades and production stabilization. Develop functional specifications and reporting requirements to support operational KPIs. This 3-5 month contract role requires an hourly rate of $85--$95.
Required Qualifications
- Epic Tapestry Utilization Management (UM) functionality
- Prior authorization functionality
- Referral functionality
- Service authorization functionality
- Work queues
- Routing rules
- Decision trees
- SmartTools
- Templates
- SmartText
- Notifications
- Correspondence workflows
- Auto-status logic
- Event processing
- Authorization rules
- Workflow automation
- Tapestry Care Link workflows
- Provider portal workflows
- Security roles
- External user access
- Benefit plans
- Provider networks
- Care management processes
- Claims adjudication processes
- CMS requirements
- NCQA requirements
- URAC requirements
- HIPAA requirements
- State regulatory turnaround time requirements
- Functional specifications
- Configuration documentation
- System testing
- Unit testing
- Integrated testing
- Regression testing
- User acceptance testing (UAT)
- Root cause analysis
- Issue resolution
- Epic upgrades
- Enhancements
- Optimization initiatives
- Production support
- Go-live planning
- Command center support
- Post-production stabilization
- Reporting requirements
- Operational KPIs
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