Note: The job is a remote job and is open to candidates in USA. VBeyond Corporation is a healthcare transformation services firm that modernizes the administrative and clinical operations of health plans across the United States. The company is seeking a senior Epic Tapestry Configuration Consultant to assess, configure, remediate, and optimize Utilization Management and Prior Authorization workflows while partnering with clinical and technical teams through implementation and stabilization.
Responsibilities
- Lead comprehensive assessments of existing Epic Tapestry UM and PA workflows against current operational processes and regulatory requirements
- Identify and document gaps in configuration, data flow, routing logic, and automation that could hinder adoption or compliance
- Analyze defects to determine root causes, differentiating between system configuration errors, process design flaws, and end-user training issues
- Design, configure, modify, and validate Epic Tapestry workflows to align with business requirements
- Develop and implement remediation strategies for identified workflow deficiencies, ensuring fixes are standardized across similar PA/UM modules
- Optimize system performance to improve throughput times for authorization requests and reduce manual touchpoints
- Architect comprehensive test scenarios and scripts that mirror real-world operational conditions (e.g., medical necessity reviews, expedited authorizations)
- Lead testing cycles (SIT, UAT) and document outcomes, ensuring business stakeholders sign off on expected results
- Track defects through resolution, collaborating with technical teams to ensure timely closure
- Act as the primary liaison between business operations (Clinical Reviewers, UM Nurses, Authorization Specialists) and technical implementation teams
- Translate high-level operational needs into precise Epic workflow solutions
- Participate in readiness assessments, stabilization planning, and hyper-care support post go-live
Skills
- Experience: 7+ years of experience in the Healthcare Payer sector
- Certification: Active Epic Tapestry Certification is mandatory
- Domain: Extensive hands-on experience with Utilization Management , Prior Authorization , and Medical Management operations
- Proven proficiency in Epic Tapestry workflow configuration, including routing rules, work queues, and automation
- Experience validating healthcare operational workflows within Epic environments
- Ability to independently identify system deficiencies and implement corrective configuration changes
- Demonstrated ability to work directly with clinical staff (UM Nurses, Medical Directors) to refine requirements
- Exceptional problem-solving skills with a track record of troubleshooting complex operational system issues
- Experience supporting large-scale payer transformations or Epic implementations
- ✅ Epic Tapestry Certified and actively maintaining their certification
- ✅ SMEs in Prior Authorization and Utilization Management
- ✅ Experienced working side-by-side with UM Nurses , Clinical Reviewers , and Authorization Specialists
- ✅ Able to assess a workflow, identify the root cause of a gap, and •implement• the config change independently
- Experience with go-live support and stabilization phases for UM modules
- Familiarity with Appeals & Grievances , Care Management , and Medical Necessity Review processes
- Prior experience in an advisory or consulting capacity within a payer environment
Benefits
- Remote work arrangement
Company Overview