Epic Application Coordinator with State Client in San Jose CA

Profile

Qualifications and Success Factors:
Experience: 3 years of Epic application build and Epic implementation experience at a health plan or health care provider (5 years preferred)
Certification:
Submitted resources should have one or more of the following certifications to be considered.
Category Set
Applications Covered
Certifications / Supplemental badges and training needed
1
Healthy Planet with Epic Care Link
Health Planet Analytics and Clinical Build Epic Care Link
2
Healthy Planet
Health Planet Analytics and Clinical Build
3
Membership Premium Billing
Data Courier
Tapestry Eligibility and Enrollment Administration Tapestry Premium Billing Administration Data Courier Mover
4
Membership Benefits Engine
Tapestry Eligibility and Enrollment Administration Benefits Engine
5
Membership MyChart CRM
Tapestry CRM Administration MYC200
6
Medical Management
Referrals and Authorizations for Tapestry Organizations
7
Medical Management Plan Link
Referrals and Authorizations for Tapestry Organizations Tap121i
8
Claims Administration
Tapestry Claims Administration
9
Claims / Contracts
Tapestry Claims and Contracts Administration
10
Accounts Payable
Tapestry Accounts Payable Administration
Desirable Qualifications:
Experience in business analysis and project management.
Knowledge of healthcare and health insurance regulatory standards.
Epic implementation experience specifically at a health plan.
Understanding relationships of providers and their processes in the healthcare continuum (primary care, specialists, lab ordering, surgery).
Familiarity with case management workflows and wellness programs. Familiarity with or background in quality reporting initiatives such as PQRS, ACOs/MSSP, and MU.
Familiarity with health plan concepts and workflows.
Understanding of operations within the AP Claims department, including claim intake, review, and payment.
Familiarity with integration points with other areas of business, such as eligibility, authorizations, and internal claims.
Familiarity with the benefit structures of plans.
Familiarity with the use of care plans to coordinate care for members/patients.
Familiarity with managed care contracting.
Understanding of treatment authorization polices/processes that affect approvals or denials and the concepts of treatment referrals and the processes followed.
Elegant Enterprise- Wide Solutions Inc

Company info

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