Epic Payor Platform Applications Analyst
About The Position
The Epic Payor Platform Applications Analyst/Health Data Management Exchange Analyst collaborates with internal business and technical teams, external provider organizations, and vendors to support implementation, configuration, and optimization of Epic Payer Platform applications. The role enables and maintains bidirectional exchange of clinical and administrative data between the health plan and provider partners, supporting clinical data exchange, prior authorization, claims, and other Payer Platform capabilities. The analyst supports payer-provider interoperability by configuring and troubleshooting applications, integrations, and workflows; onboarding, testing, and optimizing provider integrations; monitoring system performance and data quality; and identifying process improvements. The role also develops documentation, workflows, and training materials, and uses reporting and analytics to monitor performance, identify trends, and support decisions that improve operational efficiency, provider engagement, and member outcomes. The position is classified as a level-three security role and must protect the security and confidentiality of records and information and maintain information integrity in accordance with company policies. It is identified as a sedentary general office worker role, normally performed in an office or remotely, with routine campus travel within walking distance of the primary work assignment.
Requirements
- Bachelor’s degree in Business, Healthcare, Nursing, Health Administration, Computer Science, or a related field; alternatively, five years of related experience in addition to the listed experience requirements may substitute for the degree.
- At least five years of experience in healthcare information technology, health plan operations, or clinical data exchange.
- Experience with healthcare data standards and interoperability concepts such as FHIR and HL7.
- Experience analyzing data quality, mapping, and system performance to drive process improvements.
- Knowledge of payer-provider workflows, including prior authorization, claims, care management, and quality reporting such as HEDIS.
- Demonstrated ability to work with external provider organizations and vendors to support integrations and data exchange.
- Skills in analyzing information, application platforms, cross-functional communications, decision-making, documentation, evaluating information, inductive reasoning, integration architecture, interpersonal communication, organizing, problem-solving, processing information, researching, and interpreting results.
- Ability to comply with security and confidentiality requirements and segregation-of-duties guidelines.
Nice To Haves
- Experience supporting Epic applications, preferably Tapestry and/or Payer Platform functionality.
Responsibilities
- Configure and support Epic Payer Platform applications to enable payer-provider interoperability.
- Collaborate with internal stakeholders and vendors on system enhancements, upgrades, and adoption of new features.
- Develop and maintain documentation, workflows, and end-user training materials.
- Ensure timely and accurate data exchange to support risk adjustment, care gap closure, quality measurement such as HEDIS, and member longitudinal health records.
- Evaluate system performance, monitor data quality and mapping, and identify opportunities to improve operational efficiency, reduce administrative burden, and enhance provider engagement.
- Identify and implement process improvements to improve efficiency and reduce administrative burden.
- Use reporting and analytics to monitor performance, identify trends, and support decision-making.
- Monitor and ensure data quality, accuracy, and appropriate mapping across systems.
- Partner with internal stakeholders, vendors, and provider teams to troubleshoot issues, support enhancements, and drive adoption of Payer Platform capabilities.
- Partner with providers to onboard, test, and optimize Payer Platform integrations and workflows.
- Troubleshoot application, integration, and workflow issues across payer and provider environments.
- Adhere to security, confidentiality, information integrity, and segregation-of-duties requirements in the company Administrative Manual.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
