Epic Tapestry SME

Healthcare IS; United States; On-site; USD 120,000 - 180,000; Full time

Job summary

Healthcare IS seeks an Epic Tapestry SME to serve as the primary expert on Epic’s Tapestry module, supporting managed care operations across enrollment, eligibility, benefits, claims, UM, contracts, and CRM.

The role focuses on configuration, optimization, implementation support, troubleshooting, and acting as a go-to advisor between business stakeholders and IT/Epic teams. Extensive collaboration with multiple Epic modules is required.

Qualifications

• Current Epic Tapestry certification(s) in one or more areas (e.g., Claims, Membership & Enrollment, Utilization Management, Benefits Engine, Contracts).

Responsibilities

• Configure, build, maintain, and optimize Epic Tapestry applications (e.g., Claims, Membership/Enrollment & Eligibility, Benefits Engine, UM/Service Authorizations, Contracts, CRM, AP, Premium Billing).
• Analyze business/operational requirements and translate them into system design and configuration decisions.
• Lead or support design workshops, impact analysis for change requests, and standard/best-practice builds.
• Perform unit, system, integration, and UAT testing; create test scripts; triage and resolve defects.
• Support go-lives, upgrades, enhancements, cutover, and hyper-care.
• Troubleshoot complex issues related to claims adjudication, benefits, eligibility, authorizations, contracts, and integrations.
• Document builds, decision rationale, workflows, requirements configuration testing, and maintain traceability.
• Collaborate with clinical, revenue cycle, enrollment, claims, provider contracting, compliance, and other Epic teams.
• Serve as mentor/SME to analysts and end users; provide training and knowledge transfer.
• Ensure compliance with HIPAA, ANSI X12, and change control standards.
• Develop or support reports/analytics (Clarity, Reporting Workbench, Caboodle) and interfaces as needed.
• Participate in project governance, status reporting, risk/issue tracking, and continuous improvement initiatives.

Skills

Epic Tapestry

Analytical thinking

Documentation

Tools

Clarity

Cogito

Caboodle

Reporting Workbench

Job description

The Epic Tapestry SME serves as the primary expert on Epic’s Tapestry module (Epic’s managed care / payer administration platform). Tapestry supports health plan and managed care operations, including member enrollment & eligibility, benefits configuration, claims adjudication, utilization management (UM)/authorizations, provider contracting/networks, premium billing, accounts payable, CRM, and related workflows.

The role focuses on configuration, optimization, implementation support, troubleshooting, and acting as the go-to advisor between business/operations stakeholders and IT/Epic teams. Positions are commonly found at health plans, provider-sponsored plans, pay-viders, large health systems with risk-bearing arrangements, and consulting firms.

Key Responsibilities

• Configure, build, maintain, and optimize Epic Tapestry applications (e.g., Claims, Membership/Enrollment & Eligibility, Benefits Engine, Utilization Management/Service Authorizations, Contracts, CRM, AP, Premium Billing).
• Analyze business/operational requirements and translate them into system design, workflows, and configuration decisions.
• Lead or support design workshops, impact analysis for change requests, and recommendation of standardized/best-practice builds.
• Perform unit, system, integrated, and user acceptance testing (UAT); create test scripts; triage and resolve defects.
• Support go-lives, upgrades, enhancements, cutover, and hyper-care (including on-call as needed).
• Troubleshoot complex issues related to claims adjudication, benefits, eligibility, authorizations, contracts, and integrations.
• Document builds, decision rationale, workflows, processes, and maintain traceability (requirements configuration testing).
• Collaborate with clinical, revenue cycle, enrollment, claims, provider contracting, compliance, and other Epic teams (e.g., Resolute, Bridges, Clarity/Cogito).
• Serve as mentor/SME to analysts, end users, and project teams; provide training and knowledge transfer.
• Ensure compliance with regulatory requirements (e.g., HIPAA, ANSI X12 transactions), organizational policies, and change control standards.
• Develop or support reports/analytics (Clarity, Reporting Workbench, Caboodle) and interfaces as needed.
• Participate in project governance, status reporting, risk/issue tracking, and continuous improvement initiatives.

Required Qualifications

• Current Epic Tapestry certification(s) in one or more areas (e.g., Claims, Membership/Enrollment & Eligibility, Utilization Management, Benefits Engine, Contracts Administration, CRM, Accounts Payable, Premium Billing). Multiple certifications preferred.
• 3+ years of hands-on Epic Tapestry experience (build, configuration, testing, support, and/or implementation), with stronger preference for 5+ years for senior/SME roles.
• Solid understanding of managed care / health plan operations (claims processing, benefits, eligibility, authorizations/UM, provider networks/contracts).
• Experience with full-cycle Epic implementations, optimizations, or upgrades.
• Strong analytical, problem-solving, and documentation skills.