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Epic Tapestry Utilization Management

Role overview

Qualifications

  • Experience with Epic Tapestry Utilization Management
  • Knowledge of CMS, NCQA, HIPAA, and state regulatory requirements
  • Strong analytical skills
  • Ability to collaborate with cross-functional teams

Responsibilities

  • Design, build, configure, and maintain Epic Tapestry Utilization Management workflows
  • Partner with operational leaders to analyze business requirements and develop future-state workflows
  • Conduct system testing including unit, integrated, regression, and user acceptance testing (UAT)
  • Support Epic upgrades, enhancements, optimization initiatives, and production support

About the company

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Chartis

Chartis is a leading healthcare advisory services firm serving healthcare providers, payers, health service and technology companies, and investors. Chartis brings an unparalleled breadth and depth of expertise in strategy, performance improvement, digital and technology, clinical quality and patient safety, health equity and belonging, and strategic communications. Learn how Chartis is helping to build a healthier world at www.chartis.com.

Company details

Company size501 - 1000

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Job description

About Chartis

The challenges facing US healthcare are longstanding and all too familiar. We are Chartis, and we believe in better. We work with more than 1,900 organizations annually to develop and activate transformative strategies, operating models, and organizational enterprises that make US healthcare more affordable, accessible, safe, and human. With more than 1,450 professionals, we help providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better. Our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—is 100% focused on healthcare and each has a longstanding commitment to helping transform healthcare in big and small ways. Believe in better.

 

Chartis has offices in Boston, Chicago, New York, Washington D.C., and Nashville. Remote work is allowed.

Epic Tapestry Utilization Management (UM) Analyst

Position Summary

This is a contract role for 3-5 months with a possible extension.

The Epic Tapestry Utilization Management (UM) Analyst is responsible for the design, configuration, implementation, optimization, and ongoing support of Epic Tapestry Utilization Management functionality. This role partners with Utilization Management, Care Management, Case Management, Provider Relations, Medical Directors, Claims, and IT teams to streamline prior authorization and referral workflows while ensuring compliance with CMS, NCQA, HIPAA, and state regulatory requirements. The analyst serves as the subject matter expert for Epic Tapestry UM, translating operational requirements into scalable Epic solutions that improve efficiency, reduce administrative burden, and enhance member and provider experiences.

Key Responsibilities

  • Design, build, configure, and maintain Epic Tapestry Utilization Management workflows.

  • Configure prior authorization, referral, and service authorization functionality.

  • Build and maintain work queues, routing rules, decision trees, SmartTools, templates, SmartText, notifications, and correspondence workflows.

  • Configure auto-status logic, event processing, authorization rules, and workflow automation.

  • Partner with operational leaders to analyze business requirements and develop future-state workflows.

  • Collaborate with clinical reviewers, provider relations, care management, claims, and revenue cycle teams to optimize end-to-end UM processes.

  • Configure Tapestry Care Link workflows for external providers, delegated entities, and network partners.

  • Support provider portal workflows, security roles, and external user access.

  • Ensure UM workflows align with benefit plans, provider networks, care management, and claims adjudication processes.

  • Participate in design sessions, workflow validation, and solution recommendations.

  • Develop functional specifications and configuration documentation.

  • Perform system testing including unit, integrated, regression, and user acceptance testing (UAT).

  • Troubleshoot application issues, perform root cause analysis, and coordinate issue resolution.

  • Support Epic upgrades, enhancements, optimization initiatives, and production support.

  • Participate in go-live planning, command center support, and post-production stabilization.

  • Develop reporting requirements and collaborate with reporting teams to support operational KPIs.

  • Ensure compliance with CMS, NCQA, URAC, HIPAA, and state regulatory turnaround time requirements.

Hourly range: $85--$95. The hourly range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs.

At Chartis, we pride ourselves on having a diverse workforce. We value and celebrate the uniqueness of individuals and the different perspectives they provide. We offer equal opportunity employment regardless of race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, or protected veteran status.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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