Job#:2116 - Epic Tapestry UM Analyst
Job Description:
We are seeking an experienced Epic Tapestry Utilization Management (UM) Analyst to design, build, optimize, and support UM processes focused on authorizations and referrals. The ideal candidate will have active Epic Tapestry UM Certification, hands-on experience with Tapestry Care Link, and expertise in translating payer operations needs into scalable Epic solutions.
Key Responsibilities:
- Configure and optimize Epic Tapestry UM workflows for prior authorizations and referrals.
- Build routing rules, workqueues, templates, notifications, and decision support tools.
- Support Tapestry Care Link for external provider/referral workflows, including security and training.
- Align UM workflows with benefit plans, provider networks, care management, and claims processes.
- Ensure compliance with CMS, HIPAA, NCQA, and state UM regulations.
- Support testing cycles (Unit, SIT, UAT), defect resolution, releases, and hypercare.
- Develop and analyze reports for UM KPIs using SQL/Clarity/Caboodle/SlicerDicer.
- Collaborate with business and technical teams to gather requirements and deliver solutions.
Required Skills:
- Active Epic Tapestry Utilization Management Certification.
- 3–5+ years of Epic Tapestry UM build/support experience in authorizations and referrals.
- Experience implementing/supporting Tapestry Care Link.
- Strong knowledge of UM workflows, routing rules, letters, SLAs, denials, and appeals.
- Familiarity with payer operations and healthcare regulations.
- Experience in testing, defect management, and production support.
- Strong analytical, communication, and documentation skills.
