EPIC Tapestry

Job Description : - Job Title: EPIC Tapestry ConsultantEmployment Type: Full-Time / Permanent Location: RemoteCompany OverviewWe are a premier healthcare transformation services firm dedicated to modernizing the administrative and clinical operations of health plans across the United States. We partner with large healthcare payers to streamline complex processes, enhance member experiences, and reduce administrative waste. As we launch a significant payer transformation initiative, we are looking for a permanent, senior-level expert to embed within our team and drive lasting change.Position SummaryWe are seeking a highly experienced Epic Tapestry Configuration Consultant with deep expertise in Utilization Management (UM) and Prior Authorization (PA) . In this permanent role, you will not only execute configuration changes but will serve as a strategic partner to our operations teams. You will lead workflow assessments, identify systemic gaps, remediate configuration defects, and ensure that our Epic Tapestry environment is optimized for compliance, efficiency, and user satisfaction.This is not a maintenance role; it is a transformation role. You will be responsible for bridging the gap between clinical business requirements (UM Nurses, Medical Directors) and technical system configurations to ensure a successful go-live and post-implementation stabilization.Key Responsibilities1. Workflow Strategy & AssessmentLead comprehensive assessments of existing Epic Tapestry UM and PA workflows against current operational processes and regulatory requirements.Identify and document gaps in configuration, data flow, routing logic, and automation that could hinder adoption or compliance.Analyze defects to determine root causes, differentiating between system configuration errors, process design flaws, and end-user training issues.2. Configuration & RemediationDesign, configure, modify, and validate Epic Tapestry workflows to align with business requirements.Develop and implement remediation strategies for identified workflow deficiencies, ensuring fixes are standardized across similar PA/UM modules.Optimize system performance to improve throughput times for authorization requests and reduce manual touchpoints.3. Testing & Quality AssuranceArchitect comprehensive test scenarios and scripts that mirror real-world operational conditions (e.g., medical necessity reviews, expedited authorizations).Lead testing cycles (SIT, UAT) and document outcomes, ensuring business stakeholders sign off on expected results.Track defects through resolution, collaborating with technical teams to ensure timely closure.4. Stakeholder Engagement & PartnershipAct as the primary liaison between business operations (Clinical Reviewers, UM Nurses, Authorization Specialists) and technical implementation teams.Translate high-level operational needs into precise Epic workflow solutions.Participate in readiness assessments, stabilization planning, and hyper-care support post go-live.Required QualificationsEducation & ExperienceExperience: 7+ years of experience in the Healthcare Payer sector.Certification: Active Epic Tapestry Certification is mandatory.Domain: Extensive hands-on experience with Utilization Management, Prior Authorization, and Medical Management operations.Technical SkillsProven proficiency in Epic Tapestry workflow configuration, including routing rules, work queues, and automation.Experience validating healthcare operational workflows within Epic environments.Ability to independently identify system deficiencies and implement corrective configuration changes.Soft Skills & CollaborationDemonstrated ability to work directly with clinical staff (UM Nurses, Medical Directors) to refine requirements.Exceptional problem-solving skills with a track record of troubleshooting complex operational system issues.Experience supporting large-scale payer transformations or Epic implementations.Preferred QualificationsExperience with go-live support and stabilization phases for UM modules.Familiarity with Appeals & Grievances, Care Management, and Medical Necessity Review processes.Prior experience in an advisory or consulting capacity within a payer environment.What We Are Looking For (The "Perfect Fit")We are prioritizing candidates who are:✅ Epic Tapestry Certified and actively maintaining their certification.✅ SMEs in Prior Authorization and Utilization Management.✅ Experienced working side-by-side with UM Nurses, Clinical Reviewers, and Authorization Specialists.✅ Able to assess a workflow, identify the root cause of a gap, and implement the config change independently.❌ Not a good fit if you are solely a QA tester or a generalist BA without deep UM/PA experience.