Utilization Management (UM) Analyst

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $90 - $110 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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Chartis

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💼 Consulting

💰 Private Equity Round on 2012-12

Healthcare • Healthcare Insurance • Consulting

Chartis is a healthcare management consulting firm focused on transforming the US healthcare system. The company offers a wide range of services including strategic transformation, financial transformation, digital and technology transformation, and clinical transformation. Chartis specializes in helping providers, payers, and investors navigate the complexities of healthcare, with a strong emphasis on health equity, strategic communications, and mergers and integration. They are recognized as the Best Overall Management Consulting Firm by KLAS and work with a diverse clientele including academic medical centers and health systems across the United States. Their mission is to improve the delivery of healthcare by providing innovative solutions tailored to the unique challenges faced by their clients.

📋 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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