Epic Payer Platform Operations Analyst

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 ensures 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. The analyst manages operational runbooks, environment readiness, connectivity, security, and incident response while driving continuous improvement across FHIR/EDI integrations and Epic interfaces.

• Support 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 life cycles and client registrations.
• Support EDI/X12 transactions (270/271 eligibility, 276/277 claim status, 278 prior auth, 834 enrollment, 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).

• 1+ years administering healthcare interoperability platforms (Epic, payer APIs/interfaces, or equivalent) or educational equivalent.
• Experience with Agile Software Development Life Cycle.
• Excellent communication, documentation, and cross-functional collaboration skills.

• 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.
• Operational Excellence:
  Reliable execution, disciplined change control, strong service orientation.
• Analytical Problem Solving:
  Skilled at root cause analysis across network, identity, payload, and workflow layers.
• Security Mindset:
  Designs and operates with least privilege, zero trust principles, and auditability.
• Continuous Improvement:
  Data‑driven approach to reducing friction and cycle times.

• Epic Payer Platform or related Epic certifications (preferred).