Genesis10 is currently seeking a Tapestry UM Analyst for a 3-month contract role with our client. This role will be 100% remote. Compensation: $80.00 - 90.00 per hour, W2, depending on skill and experience level. Summary: We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on authorizations and referrals. The ideal candidate is Epic Tapestry UM Certified, has practical experience with Tapestry Care Link, and is adept at translating payer and network operations needs into scalable Epic solutions. You will partner with UM leadership, clinical reviewers, provider relations, care management, claims, and integration teams to enable compliant, efficient, and transparent UM determinations that reduce administrative burden and improve member and provider experience.
Key Responsibilities - Solution Design & Build
- Configure and optimize Tapestry UM workflows for prior authorizations (e.g., medical, behavioral health, pharmacy-to-medical crossovers) and referrals (in- and out-of-network), including routing rules, WQs, templates, smart text, decision trees, and notification logic.
- Leverage Tapestry Care Link for external provider access-set up roles, security, workflows, documentation tools, and training materials to support referring providers, delegated entities, and partners.
- Align UM workflows with benefit plan configuration, provider network tiering, care management touchpoints, and claims adjudication
Qualifications - The candidate must have an active Epic Tapestry Utilization Management Certification, with 3-5+ years of hands-on experience in building and supporting Epic Tapestry UM systems, specifically focused on UM authorizations and referrals.
- They should demonstrate experience in implementing and supporting Tapestry Care Link for external provider and referral workflows.
- The ideal candidate will have proven abilities in configuring UM routing rules, workqueues, decision-making tools, letters, notifications, and SLAs. Additionally, a solid understanding of payer operations and UM regulations, including CMS timelines, state TATs, HIPAA, NCQA, and pathways for denial and appeal, is essential.
- Experience in the entire testing lifecycle from unit testing to SIT, UAT, defect management, and release/hypercare processes is required.
- The candidate should possess strong analytical skills and be proficient in SQL/Clarity/Caboodle/SlicerDicer (read/interpret) and operational reporting for UM KPIs. Effective communication skills are crucial, including the ability to translate business requirements into system designs and strong documentation and presentation capabilities.
- Additional Epic credentials, such as Tapestry Benefits/Contracts, Claims, Care Management, Member Enrollment, and Security, are highly desirable. Experience with EDI X12 278/275 workflows and payer integration patterns, familiarity with industry clinical criteria tools such as InterQual and MCG, and experience in attachment management are valuable assets.
- Exposure to provider portal strategies and oversight of delegated entities, a clinical background (e.g., RN) or significant experience partnering with clinical reviewers and Medical Directors, and prior experience in payers/health plans, delegated risk provider groups, or large Integrated Delivery Networks (IDNs) with plan operations would be beneficial.
If you have the described qualifications and are interested in this exciting opportunity, apply today! Ranked a Top Staffing Firm in the U.S. by Staffing Industry Analysts for six consecutive years, Genesis10 puts thousands of consultants and employees to work across the United States every year in contract, contract-for-hire, and permanent placement roles. With more than 300 active clients, Genesis10 provides access to many of the Fortune 100 firms and a variety of mid-market organizations across the full spectrum of industry verticals.
For contract roles, Genesis10 offers the benefits listed below. If this is a perm-placement opportunity, our recruiter can talk you through the unique benefits offered for that particular client.
Benefits of Working with Genesis10: Access to hundreds of clients, most of whom have been working with Genesis10 for 5-20+ years.
The opportunity to have a career and a home in Genesis10; many of our consultants have been working exclusively with Genesis10 for years.
Access to an experienced, caring recruiting team (more than 7 years of experience, on average.)
Behavioral Health Platform
Medical, Dental, Vision
Health Savings Account
Voluntary Hospital Indemnity (Critical Illness & Accident)
Voluntary Term Life Insurance
401K
Sick Pay (for applicable states/municipalities)
Commuter Benefits (Dallas, NYC, SF)
Remote opportunities available
For multiple years running, Genesis10 has been recognized as a Top Staffing Firm in the U.S., as a Best Company for Work-Life Balance, as a Best Company for Career Growth, for Diversity, and for Leadership, amongst others. To learn more and to view all our available career opportunities, please visit us at
Genesis10 is an Equal Opportunity Employer. Candidates will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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