EPIC Payer Platform Analyst

Duration: 6 months to start�

Job Summary

The Business Systems Analyst leverages strong healthcare and technical expertise to bridge the gap between business needs and IT capabilities, with a primary focus on the Epic Payer Platform and health data interoperability standards. This role will analyze, design, and configure complex business and clinical systems using Epic, including facilitating data exchange through Epic Bridges and APIs with SMART on FHIR applications. The analyst will also be instrumental in supporting reporting needs using Epic's Cogito tools, especially related to critical payer data like eligibility, claims, and membership.

Key Responsibilities

System Analysis and Design:

• Analyze, evaluate, and document complex business requirements from various departments, including clinical, claims, and member services.
• Translate business needs into clear, actionable functional and technical specifications for system configuration, enhancements, and new feature development.
• Serve as a subject matter expert for the Epic Payer Platform, focusing on its data integration with external systems.
  
  

Epic Payer Platform Configuration And Optimization

• Configure, test, and maintain designated Epic modules within the Payer Platform to support business operations and optimize workflows.
• Collaborate with end-users and super-users during implementation and upgrades to ensure seamless system functionality.
• Troubleshoot and resolve technical issues related to Epic applications, working with IT and vendors as needed.
  
  

Interoperability, Epic Bridges, and FHIR Integration:

• Drive the implementation of data exchange initiatives using modern interoperability standards, with an emphasis on FHIR, SMART on FHIR, and the Epic Bridges module.
• Design, configure, and troubleshoot interfaces to ensure seamless data exchange between Epic and other applications.
• Partner with stakeholders to define requirements for API-based data exchange, including RESTful APIs and other FHIR resources.
• Support the integration of third-party SMART on FHIR applications to enhance member experience, clinical care coordination, and provider access to data.
  
  

Data and Reporting (Cogito):

• Leverage Epic's Cogito reporting suite (e.g., Radar, Reporting Workbench, Slicer Dicer) to meet business intelligence and reporting needs.
• Focus on analytics and reporting related to core payer data, including member eligibility, claims processing, and membership.
• Extract, analyze, and validate data to support decision-making, quality improvement, and regulatory compliance.
• Develop and maintain custom reports and dashboards and assist with data validation and quality assurance.
  
  

Minimum Qualifications

• Bachelor's degree in a relevant field such as Health Informatics, Computer Science, or Information Systems; or equivalent work experience.
• 3 5 years of experience as a Business Systems Analyst in a healthcare-related environment.
• 3 years experience with Epic systems, particularly the Epic Payer Platform.
• 3 years experience with Epic Bridges interface functionality.
• 3 years experience with Epic's Cogito reporting capabilities, including Reporting Workbench or Slicer Dicer.
• Strong understanding of healthcare data related to member eligibility, claims, and membership.
• Strong understanding of healthcare data interoperability standards, particularly HL7 FHIR and SMART on FHIR.
• Excellent analytical, problem-solving, and communication skills.
  
  

Preferred Qualifications

• Epic certification in one or more Payer-related or Cogito modules.
• Proficiency in writing SQL queries for data validation and analysis.
• Experience with Agile and Scrum methodologies.