Epic Tapestry UM Analyst

Description

We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on authorizations and referrals. The ideal candidate is Epic Tapestry UM Certified, has practical experience with Tapestry Care Link, and is adept at translating payer and network operations needs into scalable Epic solutions. You will partner with UM leadership, clinical reviewers, provider relations, care management, claims, and integration teams to enable compliant, efficient, and transparent UM determinations that reduce administrative burden and improve member and provider experience. Key Responsibilities 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

Skills

Epic, Tapestry, UM, Claim, Health care

Top Skills Details

Epic,Tapestry,UM,Claim,Health care

Additional Skills & Qualifications

Summary: The candidate must have an active Epic Tapestry Utilization Management Certification, with 3–5+ years of hands-on experience in building and supporting Epic Tapestry UM systems, specifically focused on UM authorizations and referrals. They should demonstrate experience in implementing and supporting Tapestry Care Link for external provider and referral workflows. The ideal candidate will have proven abilities in configuring UM routing rules, workqueues, decision-making tools, letters, notifications, and SLAs. Additionally, a solid understanding of payer operations and UM regulations, including CMS timelines, state TATs, HIPAA, NCQA, and pathways for denial and appeal, is essential. Experience in the entire testing lifecycle from unit testing to SIT, UAT, defect management, and release/hypercare processes is required. The candidate should possess strong analytical skills and be proficient in SQL/Clarity/Caboodle/SlicerDicer (read/interpret) and operational reporting for UM KPIs. Effective communication skills are crucial, including the ability to translate business requirements into system designs and strong documentation and presentation capabilities. Additional Epic credentials, such as Tapestry Benefits/Contracts, Claims, Care Management, Member Enrollment, and Security, are highly desirable. Experience with EDI X12 278/275 workflows and payer integration patterns, familiarity with industry clinical criteria tools such as InterQual and MCG, and experience in attachment management are valuable assets. Exposure to provider portal strategies and oversight of delegated entities, a clinical experience (e.g., RN) or significant experience partnering with clinical reviewers and Medical Directors, and prior experience in payers/health plans, delegated risk provider groups, or large Integrated Delivery Networks (IDNs) with plan operations would be beneficial.

Experience Level

Expert Level

This is a Contract position based out of Chicago, IL.

The pay range for this position is $75.00 - $90.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully remote position.

This position is anticipated to close on Jun 12, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.