Epic Analyst

*Job Overview* *Utilization Management Tapestry Analysts* This role requires deep expertise in *Medical Management and Utilization Management operations*, including a strong understanding of the day-to-day activities of Prior Authorization nurses, reviewers, and care management teams. Resources must be capable of evaluating Epic workflows against current-state processes, identifying configuration gaps, recommending workflow improvements, and implementing configuration changes to support operational readiness and a successful go-live. The initial engagement will consist of a team of five (5) consultants who will assess workflow readiness, testing completion requirements, and overall preparedness for the planned Utilization Management go-live for early Jan. Based on their findings, the team will provide recommendations regarding staffing needs, remediation efforts, and go-live feasibility. *Duties*

• Assess and validate Epic Tapestry Utilization Management and Prior Authorization workflows.
• Perform end-to-end testing of Prior Authorization scenarios and compare workflow outcomes against client’s legacy systems and operational processes.
• Identify workflow, configuration, data, and process gaps that may impact business operations, regulatory compliance, or user adoption.
• Analyze defects and determine root causes within Epic configuration, workflow design, routing rules, decision points, and process automation.
• Configure, modify, test, and validate workflow changes within Epic Tapestry to address identified gaps and defects.
• Ensure fixes are applied consistently across similar Prior Authorization scenarios and related workflows.
• Collaborate with business stakeholders, operational leaders, and Epic teams to validate expected workflow outcomes.
• Develop test cases, execute testing cycles, document findings, and track remediation activities.
• Evaluate Utilization Management operational readiness and identify risks that may impact the planned go-live.
• Provide recommendations on testing completion, stabilization efforts, staffing requirements, and implementation readiness.
• Support go-live planning activities and help establish a realistic execution roadmap for deployment.

*Qualifications*

• 7+ years of healthcare payer experience with a focus on Medical Management, Utilization Management, Prior Authorization, or Care Management operations.
• Strong hands-on experience with Epic Tapestry, including workflow configuration and optimization.
• Deep understanding of Prior Authorization review processes and the daily workflows of UM nurses, clinical reviewers, and authorization specialists.
• Experience validating and testing healthcare operational workflows within Epic environments.
• Ability to identify workflow defects and independently determine appropriate configuration changes.
• Experience supporting large-scale payer transformations or Epic implementations.
• Ability to work directly with operational and business stakeholders to bridge business requirements with Epic functionality.