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Experience: 3+ years of Epic application build and Epic implementation experience at a health plan or health care provider (5+ years preferred)

• Client will be implementing a new Epic Tapestry platform that will consolidate the management of client key business functions. This application portfolio will cover membership and enrolment functions, utilization management / treatment authorizations referrals, case management, population health, and claims/capitation processing and payment operations.
• The new Epic Tapestry platform will also contain a series of portals for external parties to interface and do business with Client. This includes the MyChart portal for members, Tapestry Link for providers to transact with Client and Healthy Planet Link for community providers.

Resources assigned to this project will work on the multiple phases of the project including:

• Pre-planning tasks
• Workflow walkthroughs and configuration
• User and system readiness
• Training and go-live
• Post go-live support

Key Responsibilities:

• Under general supervision, these resources will provide direct Epic application support and Epic software development lifecycle for the design, development, implementation, testing, updating, integration, and maintenance of system setup, system setup and application tables.

Typical tasks:

• Analysis of workflows, data collection engines, and reporting details
• Interview end users, stakeholders, create business, functional and technical requirements documents based on captured data in accordance with departmental protocols/standards.
• Supporting the process of making the best decisions associated with choices offered by the software.
• Analysing business operations and investigating end user preferences while making build decisions
• Recommending process improvements and enhancements for better operational performance and implementing those recommendation
• Serves as a liaison between end users' workflow needs and Epic assigned implementation staff.
• Maintaining regular communication with Epic representatives, including participating in weekly project team meetings
• Working with Epic representatives, your organization's business community, and end users to ensure the system meets the organization's business needs regarding the project deliverables and timelines.
• Analysis, design, configuration, testing and evaluation of new or changed business application functionality and workflows to meet requirements; manages master file changes for new features.
• Collaborating with others as needed for Epic native reporting, Investigating, designing, developing, testing, and implementations of Epic native reports and dashboards.
• Attending/coordinating meetings to perform ongoing reviews of end user issues with workflows and system capabilities.
• Ensure interoperability between Epic applications and other supporting applications; works to ensure that inbound and outbound data interfaces and transfers are functioning as desired
• Designs, develops, modifies, and implements testing processes including scripts, recording of results, and facilitating end-user testing.
• Provides information to instructional designers to facilitate instructional training, participates in training and works with end-users Qualifications and Success Factors:

Desirable Qualifications:

• The assigned resources will collectively need the following portfolio of desirable qualifications and success factors:
• 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