Epic Application Coordinator

Epic Application Coordinator

Location: San Jose, CA – Hybrid (2 days on site)

Contract Duration: 10 months initially

Our client requires Epic Application Coordinator resources for the stabilization and support of the newly implemented Epic platform.

Tapestry Platform Implementation: Client has implemented a new Epic Tapestry platform to consolidate the management of key business functions. This application portfolio includes membership and enrollment functions, utilization management / treatment authorizations referrals, case management, population health, and claims / capitation processing and payment operations.

Key Responsibilities: Resources will provide direct Epic application support and Epic software development lifecycle for the design, development, monitoring, testing, updating, integration, and maintenance of system stabilization. Resources will analyze user, system, and application needs and will evaluate approaches to determine the best solution to meet business needs via performance of the defined itemization of responsibilities above and below.

Typical Tasks:

• Analyzing of workflows, data collection engines, and reporting details.
• Recommending process improvements and enhancements for better operational performance and implementing those recommendations within the Epic system.
• Serving 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.
• Ensuring interoperability between Epic applications and other supporting applications.

Required Skills & Abilities:

• Experience: A minimum of 1 year of application support/build/configuration and/or related business/operational analyst experience in a health plan or health care setting.

Desirable Qualifications:

• Experience or knowledge in the following areas is desired.
• 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.