Genesis10 · 17 hours ago
Epic Tapestry UM Analyst - 100% Remote
United States
Full-time
Remote
Mid, Senior Level
$80/hr - $90/hr
3+ years expGenesis10 is currently seeking a Tapestry UM Analyst for a 3-month contract role. This role involves designing, building, optimizing, and supporting UM workflows focused on prior authorizations and referrals, while collaborating with various teams to enhance the member and provider experience.
Information ServicesInformation Technology
Responsibilities
Design, configure, and optimize Epic Tapestry UM workflows for prior authorizations (medical, behavioral health, pharmacy-to-medical crossovers) and referrals (in-network and out-of-network)
Configure routing rules, workqueues (WQs), templates, SmartText, decision trees, letters, and notification logic to support UM determinations and SLAs
Implement and support Tapestry Care Link to enable secure external provider access, including role/security setup, workflows, documentation tools, and training materials
Align UM workflows with benefit plan configuration, provider network tiering, care management touchpoints, and claims adjudication
Partner with cross-functional stakeholders to ensure UM workflows support regulatory compliance, operational efficiency, and provider usability
Support the full testing lifecycle, including unit testing, SIT, UAT, defect management, releases, and hypercare
Develop and execute test scenarios for UM authorizations, referrals, and payer integrations
Analyze and interpret operational and reporting data to support UM KPIs and continuous improvement initiatives
Qualification
Required
3–5+ years of hands-on experience building and supporting Epic Tapestry Utilization Management systems, with a focus on authorizations and referrals
Experience implementing and supporting Tapestry Care Link for external provider and referral workflows
Proven expertise in configuring UM routing rules, workqueues, decision logic, letters, notifications, and SLAs
Strong understanding of payer operations and UM regulations, including CMS timelines, state TATs, HIPAA, NCQA, and denial/appeal pathways
Experience across the full testing and release lifecycle (unit testing through hypercare)
Strong analytical skills with the ability to read and interpret data using SQL, Clarity, Caboodle, and/or SlicerDicer
Excellent communication skills, with the ability to translate business and regulatory requirements into system designs and produce clear documentation and presentations
Preferred
Active Epic Tapestry Utilization Management Certification
Additional Epic certifications (Tapestry Benefits/Contracts, Claims, Care Management, Member Enrollment, Security)
Experience with EDI X12 278/275, payer integration patterns, and attachment management
Familiarity with clinical criteria tools such as InterQual and MCG
Experience supporting provider portals, delegated entities, or delegated risk models
Clinical background (e.g., RN) or significant experience partnering with clinical reviewers and Medical Directors
Prior experience with health plans, payer organizations, delegated risk provider groups, or large IDNs with plan operations
Benefits
Behavioral Health Platform
Medical, Dental, Vision
Health Savings Account
Voluntary Hospital Indemnity (Critical Illness & Accident)
Voluntary Term Life Insurance
401K
Sick Pay (for applicable states/municipalities)
Commuter Benefits (Dallas, NYC, SF)
Remote opportunities available
Company
Genesis10
Information Technology and Services
1001-5000 employees
H1B Sponsorship
Genesis10 has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (126)
2024 (68)
2023 (20)
2022 (2)
2021 (13)
2020 (29)
Funding
Current Stage
Late StageLeadership Team
Harley Lippman
CEO and Founder
Company data provided by crunchbase