Works independently with various levels of clients within the organization and with outside parties to identify operational business requirements with sufficient detail and clarity to allow for Epic IT solution proposal development. Integrates clinical systems into health care business referral operations to support revenue cycle, regulatory, and clinical initiatives. Proposes and identifies workflow/gap analysis solutions as related to the Tapestry areas of AP Claims, UM/CM, Internal and External Referrals, as well as Letters between business and systems functionality in a health care environment. Leads independent initiatives through information gathering and analysis, documentation, and the presentation of findings, and then into implementation and support.
Essential Responsibilities:Assist by providing application technical and billing operational knowledge in the analysis of client requirements in the Epic Tapestry application areas such as: to interpret business workflows and requirements, manage IT testing and product acceptance, gap analysis, development of new business operating models with innovative approaches to IT solutions, support available product functionality as it relates Tapestry configuration requirements, provide operational readiness assessment, and others. Assesses training modality & content for upcoming new Epic functionality releases as it relates to internal and external referrals like home health, hospice, long term care as well as other specialty departments.Assist and facilitate in cross functional task forces to identify and document functional requirements regarding ancillary medical systems, workflow, information sources and distribution paths, and system specifications as related to the development and support of referral functionality in the Epic application. Conducts analysis of client business processes and functional requirements and prepares appropriate documentation to communicate and validate the information.Analyzes and defines efficient, cost effective solutions which support of client business processes and functional requirements. Able to focus and advise on configurations related to the Contracts, Referrals, UC/CM, Benefits Engine areas of the Tapestry module, and pertinent master files such as Provider (SER), Place of Service (EAF) and Vendor (VEN). Key knowledge in the areas of Referral Management, Utilization Management, Claims, Payments, and Accumulations is highly recommended.Independently develop comprehensive business cases with cost, service, and benefit dimensions of proposed IT and business operations projects that are used at various levels for funding and scope decisions.Supports the implementation of initiatives into deployment using project management methodologies. Serves as a single point of contact for the resolution of client issues and acts as a liaison between business clients and IT technical staff. Advise and validate regarding systems configuration work.Performs predetermined work in system as defined by policy and procedure/protocol. Formal presentations to audiences of various leadership and executive levels. Evaluate existing application products which could address client requirements and develop recommendations where appropriate. Lead design discussions with IT partners on system enhancements and improvements. Develops test and activation support plans. Works with the client to perform risk assessments. Leads the coordination of solution development and supports implementation of initiatives into deployment. Creates and executes implementation support plans. Leads workflow discussions to support training initiatives and provides editorial review for communication messages to the end user. Functions as a subject matter expert and provides guidance and expertise to management and other team members. Completes administrative requirements in an accurate and timely manner (e.g. time reporting, status reporting, etc.).
Experience Minimum (6) years of application support experience in information systems analysis or information technology support in a Healthcare environment. Minimum (6) years of technical support in the Epic Tapestry application and working directly with business partners in implementing system changes.
Education Master's degree in health care, information systems, computer science, engineering, or related fields.
License, Certification, Registration Specific Epic certifications required in Tapestry Core, Referrals, and AP Claims. Required Epic certification in a Tapestry application module. PMI or Six Sigma certification required. Vehicle and valid driver's license required.
Additional Requirements: Strong skills in critical thinking and analysis, meeting facilitation, verbal and written communications, and interpersonal interactions (e.g., partnering, conflict management, consulting, etc.). Experience required in analyzing the Tapestry system configurations against customer requirements, designing solutions (i.e. taking EPIC basic functionality and offering optimal organizational solutions based on business requirements as well as negotiate design/solution with EPIC partners to meet organizational needs), ability to design EPIC enhancements and manage CRs through the EPIC review process, presenting to leadership and implementing approved solutions into production workflows. Knowledge of the industry standards for utilization and referral management. Excellent project management, consulting, verbal and written communication skills are required. Expert knowledge in Excel, Visual Basics, and Access. Demonstrated and applied knowledge of internal and external referrals specifically within continuum of care environment in a large HMO setting. Prior experience working in complex organization within different regional areas and with multiple stakeholders. Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications: N/A