Utilization Management (UM) Analyst

🔥 56 minutes ago

🇺🇸 United States – Remote

💵 $90 - $110 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Chartis

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2001

🏥 Healthcare

💼 Consulting

🤝 B2B

💰 Private Equity Round on 2024-08

Healthcare • Consulting • B2B

Chartis is a US-based healthcare consultancy that helps health systems, payers, investors and other healthcare organizations plan and execute large-scale transformation. The firm offers strategic transformation, digital and technology transformation, performance improvement (including revenue cycle and financial performance), payer transformation, M&A and private equity advisory, and specialized centers for AI, research, and health equity. Chartis emphasizes end-to-end transformation projects, case-study-driven results, and enterprise IT and clinical technology work, and highlights outcomes such as cost savings from EHR optimization and improvements in care delivery timelines. The organization positions itself as a B2B advisor to the healthcare sector and celebrates decades of experience and client impact.

📋 Description

• Design, build, configure, test, and maintain Epic Tapestry Utilization Management functionality • Support UM workflows, including prior authorizations, referrals, inpatient admissions, concurrent reviews, and medical necessity determinations • Configure and optimize authorization workflows, review processes, workqueues, and decision-support functionality • Collaborate with clinical and operational stakeholders to identify workflow improvements and translate business requirements into Epic solutions • Support Epic Tapestry implementations, upgrades, enhancements, integrated testing, and go-live activities • Troubleshoot application issues, resolve defects, and provide ongoing production support • Work with Tapestry Claims, Membership, Provider Management, and clinical applications teams to ensure integrated workflows • Support regulatory and compliance requirements related to utilization management, including CMS and NCQA standards • Develop functional specifications, testing scenarios, and system documentation • Provide end-user support and knowledge transfer to operational teams

🎯 Requirements

• Epic Tapestry Utilization Management certification required • Hands-on experience with Epic Tapestry UM build, configuration, testing, and optimization • Strong understanding of managed care operations, prior authorization, referrals, and utilization review processes • Experience supporting Epic implementations, upgrades, and production environments • Ability to analyze complex workflows, troubleshoot technical issues, and recommend improvements • Strong communication skills and experience working with clinical, operational, and IT stakeholders • Legally authorized to work in the United States

🏖️ Benefits

• Remote work is allowed • Equal opportunity employment • Diverse and inclusive workforce

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