Acceptance Testing, Adjudication, Analysis Skills, Apache Tapestry, Bug Tracking/Defect Management, Business Skills, Communication Skills, Compensation and Benefits, Content Management Systems (CMS), Documentation, Epic Certification, Epic Systems, Epic Tapestry, HIPAA (Health Insurance Portability and Accountability Act), Healthcare Providers, Leadership, National Committee for Quality Assurance (NCQA), Network Administration/Management, Operations Processes, Performance Metrics, Provider Relations, Regulations, Requirements Management, SQL (Structured Query Language), Unit Test, Utilization Management
Job Title: Epic Tapestry Utilization Management Analyst
Location: Eden Prairie, MN
Long Term Contract
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
Required skills:
Epic Tapestry Utilization Management Certification (active).
3–5+ years hands-on Epic Tapestry UM build/support experience specifically in UM authorizations and referrals.
Demonstrated experience implementing and supporting Tapestry Care Link for external provider/referral workflows.
Proven ability to configure UM routing rules, work queues, decisioning tools, letters/notifications, and SLAs.
Solid understanding of payer operations and UM regulations (e.g., CMS timelines, state TATs, HIPAA, NCQA), including denial and appeal pathways.
Experience with testing lifecycle (unit ? SIT ? UAT), defect management, and release/hypercare processes.
Strong analytical skills; proficiency with SQL/Clarity/Caboodle/SlicerDicer (read/interpret) and operational reporting for UM KPIs.
Effective communicator with the ability to translate business requirements into system design; strong documentation and presentation skills.
Recruiter Submission Template –
Full Name:
Total Years of Epic Tapestry Experience:
Epic Tapestry Utilization Management Certification (Active): (Yes/No – Year)
Total Years of Utilization Management (UM) Experience:
Total Years of Experience in Authorizations (UM):
Total Years of Experience in Referrals (UM):
Total Years of Experience with Tapestry Care Link (Must-have):
Total Years of Experience in UM Workflow Configuration (Routing Rules, WQs, Decision Logic):
Total Years of Experience with Letters / Notifications / Templates / SmartText:
Total Years of Experience with Prior Authorization Workflows:
Total Years of Experience with Referral Management (In/Out-of-Network):
Total Years of Experience with Payer Operations (UM processes):
Motivation / Reason for Relocation (if not local):
Motivation / Reason for interest in this position:
Contact Number:
Email ID:
LinkedIn Profile URL:
Full Address (Street, City, State, Zip Code):
Notice Period (in weeks):
Current Work Authorization Status:
Expected Hourly Rates on W2:
Are you able to relocate on your own expenses and work 100% ON-SITE in Eden Prairie, MN?