Epic Tapestry UM Analyst

Solution Design & Build

• Configure and optimize Tapestry UM workflows for prior authorizations (e.g., medical, behavioral health, pharmacy-to-medical crossovers) and referrals (in- and out-of-network), including routing rules, WQs, templates, smart text, decision trees, and notification logic.
• Leverage Tapestry Care Link for external provider access—set up roles, security, workflows, documentation tools, and training materials to support referring providers, delegated entities, and partners.
• Align UM workflows with benefit plan configuration, provider network tiering, care management touchpoints, and claims adjudication.

Required skills

• Epic Tapestry Utilization Management Certification (active).
• 3–5+ years hands-on Epic Tapestry UM build/support experience specifically in UM authorizations and referrals.
• Demonstrated experience implementing and supporting Tapestry Care Link for external provider/referral workflows.
• Prominent ability to configure UM routing rules, workqueues, decisioning tools, letters/notifications, and SLAs.
• Solid understanding of payer operations and UM regulations (e.g., CMS timelines, state TATs, HIPAA, NCQA), including denial and appeal pathways.
• Experience with testing lifecycle (unit → SIT → UAT), defect management, and release/hypercare processes.
• Strong analytical skills; proficiency with SQL/Clarity/Caboodle/SlicerDicer (read/interpret) and operational reporting for UM KPIs.
• Effective communicator with the ability to translate business requirements into system design; strong documentation and presentation skills.

Compensation

$50.00 per hour

About the role

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Vytwo Technologies is a global leader in enterprise application integration, delivering end-to-end IT consulting and business services for mid to large-scale organizations. We offer a comprehensive suite of solutions including business and technology consulting, Cloud, e-business and digital transformation services, system integration, custom application development, re-engineering, and long-term application support.

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