Report this job

---

What is the problem? *

Incorrect company
Incorrect location
Job is expired
Job may be a scam
Other

Qualifications and Success Factors:
Experience: 3+ years of Epic application build and Epic implementation experience at a health plan or health care provider (5+ years preferred)
Certification: Submitted resources should have one or more of the following certifications to be considered.

Category Set	Applications Covered	Certifications / Supplemental badges and training needed
1	Healthy Planet with Epic Care Link	Health Planet Analytics and Clinical Build + Epic Care Link
2	Healthy Planet	Health Planet Analytics and Clinical Build
3	Membership + Premium Billing +Data Courier	Tapestry Eligibility and Enrollment Administration + Tapestry Premium Billing Administration + Data Courier Mover
4	Membership + Benefits Engine	Tapestry Eligibility and Enrollment Administration + Benefits Engine

5	Membership + MyChart + CRM	Tapestry CRM Administration + MYC200
6	Medical Management	Referrals and Authorizations for Tapestry Organizations
7	Medical Management + Plan Link	Referrals and Authorizations for Tapestry Organizations + Tap121i
8	Claims Administration	Tapestry Claims Administration
9	Claims / Contracts	Tapestry Claims and Contracts Administration
10	Accounts Payable	Tapestry Accounts Payable Administration

Desirable Qualifications:
Experience in business analysis and project management.
Knowledge of healthcare and health insurance regulatory standards.
Epic implementation experience specifically at a health plan.
Understanding relationships of providers and their processes in the healthcare continuum (primary care, specialists, lab ordering, surgery).
Familiarity with case management workflows and wellness programs. Familiarity with or background in quality reporting initiatives such as PQRS, ACOs/MSSP, and MU.
Familiarity with health plan concepts and workflows.
Understanding of operations within the AP Claims department, including claim intake, review, and payment.
Familiarity with integration points with other areas of business, such as eligibility, authorizations, and internal claims.
Familiarity with the benefit structures of plans.
Familiarity with the use of care plans to coordinate care for members/patients.
Familiarity with managed care contracting.
Understanding of treatment authorization polices/processes that affect approvals or denials and the concepts of treatment referrals and the processes followed.