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The Epic Payer Platform Operations Analyst is responsible for day‑to‑day administration, configuration, monitoring, and optimization of Epic’s Payer Platform capabilities for a health plan/payer organization. This role stewards secure, reliable data exchange and workflows between payer systems and Epic‑enabled provider organizations—covering eligibility, coverage discovery, prior authorization, claims status, clinical data retrieval, and care gap closure. You will manage operational runbooks, environment readiness, connectivity, security, and incident response and drive continuous improvement across FHIR/EDI integrations and Epic interfaces.
Job Responsibility:
Support the operational administration of Epic Payer Platform (e.g., Interconnect/Bridge, Payer Platform Console, Payer data sharing configurations) including environment health checks, routine maintenance, upgrades/patching, and change control
Configure, test, and maintain payer‑to‑provider workflows: coverage discovery (eligibility), prior authorization, claims status, clinical data exchange, care gap notifications, formulary/benefit, and provider inquiry/response
Maintain and execute runbooks for deployments, failover, disaster recovery, and incident management
ensure auditable change records
Administer and monitor FHIR integrations (SMART on FHIR/OAuth2/OIDC) for Da Vinci/HL7 profiles (e.g., CRD, PAS, PDex, P2P), CARIN IG for Blue Button where applicable
coordinate token lifecycles and client registrations
Support EDI/X12 transactions (270/271 eligibility, 276/277 claim status, 278 prior auth, 834 enrollment where applicable, 835 remittance) and related translation/validation processes
Collaborate with interface teams to maintain API gateways, message queues, and secure connectivity (TLS, mutual auth, certificates, VPN tunnels)
track throughput, error rates, and latency
Triage and resolve operational issues with Epic Payer Platform integrations, including authentication failures, payload validation errors, throttling, and data mismatches
Perform root cause analysis
create problem records
implement corrective actions and preventative measures
Track platform SLAs/SLOs
build dashboards for uptime, message success rates, queue depth, and retry volumes
Coordinate with Epic TS/Customer Support, vendor partners, and provider IT teams for change windows, go‑lives, and escalations
Drive adoption of best practices
Identify opportunities to, reduce provider abrasion, and improve data completeness for care gap closure
Pilot new Epic capabilities, FHIR releases, and payer use cases
contribute to controlled rollouts and measurement
Contribute to backlog grooming and quarterly planning
quantify business value (e.g., reduced turnaround time, decreased call volume, improved first‑pass rates)
Requirements:
1+ years administering healthcare interoperability platforms (Epic, payer APIs/interfaces, or equivalent) or educational equivalent
8+ Years of Experience with Agile Software Development Life Cycle
8+ Years of Excellent communication, documentation, and cross‑functional collaboration skills
Nice to have:
Epic‑related exposure (Tapestry/Payer workflows), Epic operational tools, or Epic certifications (helpful but not strictly required)
Experience with Da Vinci Implementation Guides (CRD, DTR, PAS, PDex, P2P) and CARIN BB
Familiarity with SQL for ad‑hoc data validation
Hands‑on experience with Epic concepts such as Interconnect, Chronicles awareness, Payer Platform configuration, and provider connectivity patterns