EPIC Specialist

EPIC Specialist

Job description :

Epic Tapestry Configuration Architect with 10+ years of downstream application experience. This strategic role leads the end-to-end design, build, and integration of the Epic payer platform, while utilizing deep expertise in data exchanges and QNXT to ensure seamless enterprise interoperability across health plan operations.

Role & Responsibilities

System Architecture & Design: Architect, design, and configure complex Tapestry modules (e.g., Utilization Management, Claims, Benefits, and Enrollment) to align with payer requirements.

QNXT & Core Platform Integration: Bridge the gap between Epic Tapestry and core administration platforms like QNXT. Architect robust downstream data flows to ensure accurate adjudication, accumulator tracking, and fee schedules.

Interoperability & EDI: Leverage strong knowledge of transactions to ensure smooth integration with health data exchange solutions, clearinghouses, and third-party vendors.

Leadership & Strategy: Provide technical governance and solution architecture across implementation lifecycles, from gather requirements and design through UAT and go-live support.

Operational Optimization: Collaborate with business stakeholders to troubleshoot complex claims and authorization issues, identifying root causes and defining scalable system enhancements.

Required Qualifications

Education & Certification: Active Epic Tapestry Certification (or equivalent, such as Claims, Membership, or Utilization Management). Bachelor's degree in healthcare, Information Technology, or a related field.

Experience: 10+ years of progressive experience in payer/managed care application architecture, with a heavy emphasis on downstream application suites.

System Knowledge: Deep expertise in the Epic Payer Platform and QNXT, including a strong understanding of how clinical build translates into financial and claims outcomes.

Technical Skills: Hands-on experience with ANSI mapping, provider contracts, fee schedules, and complex system troubleshooting.

Soft Skills: Excellent stakeholder management and the ability to clearly translate complex payer business rules into detailed technical configurations.