EPIC Solution Design Consultant

Pleasanton, CA - USA

Monthly Salary: Not Disclosed

Posted on: 8 hours ago

Vacancies: 1 Vacancy

Job Summary

Required Skills & Qualifications

Experience: 5 years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting
Epic Certification: Active Epic certification(s) in relevant Revenue Cycle modules (e.g. Resolute PB Resolute HB Claims Tapestry) is required.
Technical Skills: In-depth knowledge of healthcare revenue cycle operations electronic claims processing standards (e.g. EDI specific claim forms) system integration standards such as HL7 & FHIR and system configuration. Strong analytical and problem-solving skills are essential.

System Architecture & Design: Lead the design and architecture of the Epic Claims modules including Resolute Professional Billing (PB) and Hospital Billing (HB) focusing on claims billing and accounts receivable workflows.
Implementation & Configuration: Plan configure test and implement Epic software updates and new functionality translating complex business requirements into practical system solutions.
Workflow Analysis & Optimization: Collaborate with clinical and administrative leadership to perform workflow analysis identify areas for improvement and optimize system use to enhance efficiency and ensure regulatory compliance.
Integration Management: Design and manage integrations between Epic and third-party systems related to claims submission payment processing and other financial operations.
Analyze business requirements and translate them into scalable secure and compliant solution designs for healthcare and insurance domains.
Configure and optimize EPIC system workflows to support health insurance processes including eligibility claims management billing and prior authorization.
Ensure interoperability between EPIC modules and external payer systems utilizing standards such as HL7 FHIR and EDI for robust data exchange.
Collaborate with business analysts project managers and technical teams to validate requirements and design effective solutions.
Facilitate workshops with clinical administrative and payer stakeholders to gather insights and continuously improve workflows.
Configure EPIC modules (e.g. Tapestry Resolute Benefits Engine) for insurance-related functionalities and support integration strategies for claims processing eligibility verification and premium billing.
Provide expert guidance on HIPAA compliance and data security best practices throughout solution design and implementation.
Develop comprehensive solution design documentation including data flow diagrams and integration specifications maintaining compliance with organizational architecture standards and regulatory requirements.
Act as a subject matter expert for troubleshooting and optimization leading detailed design efforts and workflow planning within project squads.
Translate complex business requirements into clear actionable technical specifications and contribute to user story creation ensuring acceptance criteria are well-defined.
Develop and maintain design documentation updating regularly throughout the project lifecycle to ensure accuracy and completeness.
Collaborate with technical SMEs to provide necessary details for successful completion of development stories.
Lead design and technical discussions across squads and teams to ensure alignment integration and successful project outcomes.
Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning and work closely with other squads to define feature strategies for projects and initiatives.

Required Skills & Qualifications Experience: 5 years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting Epic Certification: Active Epic certification(s) in relevant Revenue Cycle modules (e.g. Resolute PB Resolute HB Claims Tapestry) is requ...

Required Skills & Qualifications

Experience: 5 years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting
Epic Certification: Active Epic certification(s) in relevant Revenue Cycle modules (e.g. Resolute PB Resolute HB Claims Tapestry) is required.
Technical Skills: In-depth knowledge of healthcare revenue cycle operations electronic claims processing standards (e.g. EDI specific claim forms) system integration standards such as HL7 & FHIR and system configuration. Strong analytical and problem-solving skills are essential.

System Architecture & Design: Lead the design and architecture of the Epic Claims modules including Resolute Professional Billing (PB) and Hospital Billing (HB) focusing on claims billing and accounts receivable workflows.
Implementation & Configuration: Plan configure test and implement Epic software updates and new functionality translating complex business requirements into practical system solutions.
Workflow Analysis & Optimization: Collaborate with clinical and administrative leadership to perform workflow analysis identify areas for improvement and optimize system use to enhance efficiency and ensure regulatory compliance.
Integration Management: Design and manage integrations between Epic and third-party systems related to claims submission payment processing and other financial operations.
Analyze business requirements and translate them into scalable secure and compliant solution designs for healthcare and insurance domains.
Configure and optimize EPIC system workflows to support health insurance processes including eligibility claims management billing and prior authorization.
Ensure interoperability between EPIC modules and external payer systems utilizing standards such as HL7 FHIR and EDI for robust data exchange.
Collaborate with business analysts project managers and technical teams to validate requirements and design effective solutions.
Facilitate workshops with clinical administrative and payer stakeholders to gather insights and continuously improve workflows.
Configure EPIC modules (e.g. Tapestry Resolute Benefits Engine) for insurance-related functionalities and support integration strategies for claims processing eligibility verification and premium billing.
Provide expert guidance on HIPAA compliance and data security best practices throughout solution design and implementation.
Develop comprehensive solution design documentation including data flow diagrams and integration specifications maintaining compliance with organizational architecture standards and regulatory requirements.
Act as a subject matter expert for troubleshooting and optimization leading detailed design efforts and workflow planning within project squads.
Translate complex business requirements into clear actionable technical specifications and contribute to user story creation ensuring acceptance criteria are well-defined.
Develop and maintain design documentation updating regularly throughout the project lifecycle to ensure accuracy and completeness.
Collaborate with technical SMEs to provide necessary details for successful completion of development stories.
Lead design and technical discussions across squads and teams to ensure alignment integration and successful project outcomes.
Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning and work closely with other squads to define feature strategies for projects and initiatives.