Epic Payor Platform Applications Analyst

Arkansas Blue Cross and Blue Shield; Little Rock (AR); Vor Ort; USD 85.000 - 110.000; Vollzeit

Zusammenfassung

Arkansas Blue Cross and Blue Shield is seeking an Epic Payor Platform Applications Analyst/Health Data Management Exchange Analyst to optimize data exchange between health plans and provider partners. You will drive configuration, integration, and documentation to support risk adjustment, care gaps, and quality reporting.

The role requires collaboration with internal teams and external providers, with a focus on data quality, standards like FHIR/HL7, and Epic Payer Platform capabilities to

Qualifikationen

• Bachelor’s degree in a related field required.
• Minimum five (5) years experience in healthcare IT, health plan operations, or clinical data exchange.
• Experience with healthcare data standards/interoperability concepts (e.g., FHIR, HL7).
• Experience analyzing data quality, mapping, and system performance to drive improvements.
• Experience supporting Epic applications, preferably Tapestry and/or Payer Platform functionality.

Aufgaben

• Collaborates with stakeholders and vendors on system enhancements and new feature adoption.
• Configures and supports Epic Payer Platform applications to enable interoperability.
• Develops and maintains documentation, workflows, and training materials for end users.
• Ensures timely and accurate data exchange to support risk adjustment, quality measurement, and member health records development.
• Evaluates system performance and data quality to identify efficiency improvements and reduce administrative burden.
• Troubleshoots issues across payer and provider environments to drive adoption of Payer Platform capabilities.

Kenntnisse

Analyze information

Application platforms

Cross-functional communications

Decision making

Documentation

Evaluating information

Inductive reasoning

Integration architecture

Interpersonal communication

Organizing

Problem solving

Process information

Researching

Results interpretation

Ausbildung

Bachelor’s degree

Tools

Epic Payer Platform

Tapestry

HL7

FHIR

Data mapping tools

Jobbeschreibung

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.

Job Summary

The Epic Payor Platform Applications Analyst/Health Data Management Exchange Analyst collaborates with internal business and technical teams, as well as external provider organizations, to support the implementation, configuration, and optimization of Epic Payer Platform applications. This role enables and maintains bidirectional exchange of clinical and administrative data between the health plan and provider partners, supporting workflows such as clinical data exchange, prior authorization, claims, and other Payer Platform capabilities.

Requirements

EDUCATION

Bachelor’s degree in Business, Healthcare, Nursing, Health Administration, Computer Science, or related field required.

Experience & Knowledge

• Minimum five (5) years experience in healthcare Information Technology (IT), health plan operations, or clinical data exchange required.
• Experience with healthcare data standards and interoperability concepts (e.g., FHIR, HL7).
• Experience analyzing data quality, mapping, and system performance to drive process improvements.
• Experience supporting Epic applications, preferably Tapestry and/or Payer Platform functionality, preferred.
• Knowledge of payer-provider workflows including prior authorization, claims, care management, and quality reporting (e.g., HEDIS).

Essential Abilities

Demonstrated ability to work with external provider organizations and vendors to support integrations and data exchange.

Skills

• Analyze Information
• Application Platforms
• Cross-Functional Communications
• Decision Making
• Documentations
• Evaluating Information
• Inductive Reasoning
• Integration Architecture
• Interpersonal Communication
• Organizing
• Problem Solving
• Process Information
• Researching
• Results Interpretation

Responsibilities

• Collaborates with internal stakeholders and vendors on system enhancements, upgrades, and new feature adoption.
• Configures and supports Epic Payer Platform applications to enable payer-provider interoperability.
• Develops and maintains documentation, workflows, and training materials for end users.
• Ensures timely and accurate data exchange to support risk adjustment, care gap closure, quality measurement (e.g., HEDIS), and the development of member longitudinal health records.
• Evaluates system performance, monitors data quality and mapping, and identifies opportunities to improve operational efficiency, reduce administrative burden, and enhance provider engagement.
• Identifies and implements process improvements to enhance efficiency and reduce administrative burden.
• Leverages reporting and analytics to monitor performance, identify trends, and support decision-making.
• Monitors and ensures data quality, accuracy, and appropriate mapping across systems.
• Partners with internal stakeholders, vendors, and provider teams to troubleshoot issues, support system enhancements, and drive adoption of Payer Platform capabilities that improve interoperability, streamline processes, and enable more effective, data-driven decision-making to improve member outcomes.
• Partners with providers to onboard, test, and optimize Payer Platform integrations and workflows.
• Troubleshoots application, integration, and workflow issues across payer and provider environments.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.