Tapestry UM Analyst (Utilization Management)

Required SkillsEpic Tapestry Utilization Management Certification (active).35+ years hands-on Epic Tapestry UM build/support experience specifically in UM authorizations and referrals.Demonstrated experience implementing and supporting Tapestry Care Link for external provider/referral workflows.Proven ability to configure UM routing rules, work queues, decisioning tools, letters/notifications, and SLAs.Solid understanding of payer operations and UM regulations (e.g., CMS timelines, state TATs, H

Experience: 8+ Years Visa: EAD, TN, E2, L2, (No H1B & OPT) Role 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, provide

Key Responsibilities< data-start=888 data-end=926>Solution Design & DevelopmentConfigure and optimize Tapestry UM workflows for:Prior authorizations (medical, behavioral health, and pharmacy-to-medical crossovers)Referral management (in-network and out-of-network)Build and maintain routing rules, workqueues, templates, smart texts, decision trees, and notification logicEnsure alignment of UM workflows with:Benefit plan configurationsProvider network structuresCare management processesClaims adju

Job title: Tapestry UM Analyst Location: Remote Job type: Full time and Contract c2c both Interview: Video Role Summary We are seeking an experienced Epic Tapestry 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, c