Job Description

Tracking Code28705-977Job Location12401 Washington Blvd., Whittier, California, United StatesCategoryTechnicalDetermination for the Epic Application Analyst (I, II or III), Tapestry Core Administration, Utilization Management or Benefits roles will be based on experience and qualifications.Must have Epic Certification in Tapestry Core, Utilization Management or Benefits.This position is on-site in Southern California.Tapestry Core: This position will focus primarily on the following Epic applications: Tapestry Managed Care Administration. The Epic Application Analyst, Tapestry Core Administration is the primary support contact for the above applications and will guide workflow design, build and test the system, and analyze other technical issues associated with Epic and any other connected software. This level II role independently manages more complex configurations and systems optimizations, and mentors level I analysts. Tapestry Membership: This position will focus primarily on the following Epic applications: Tapestry Managed Care Administration. The Epic Application Analyst, Tapestry Membership is the primary support contact for the above applications and will guide workflow design, build and test the system, and analyze other technical issues associated with Epic and any other connected software. Tapestry Utilization Management: This position will focus primarily on the following Epic applications: Tapestry Managed Care Administration. The Epic Application Analyst, Tapestry Medical Management is the primary support contact for the above applications and will guide workflow design, build and test the system, and analyze other technical issues associated with Epic and any other connected software. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.Required SkillsTapestry Core: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 structure of plans that your organization administers. Familiarity with your organization's managed care vendor contracts Familiarity with operations and workflows in a Management Services Organization Ability to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management. Strong analytical, technical, and troubleshooting skills Demonstrating flexibility with respect to changing end‐user business needs The ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help others The ability to communicate information clearly and concisely with project leadership and subject matter experts The ability to gain trust and establish effective relationships with Epic counterparts The ability and willingness to learn new software and systems Listening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracy Seeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrence The ability to persevere in difficult situations, overcome obstacles, and reach high levels of performance when faced with stressful work situations and time pressures Tapestry Membership: Familiarity with your managed care organization benefit structures regarding carriers, plans, and employer groups Understanding of ANSI or proprietary files receivedAbility to managing enrollment file loads from payersFamiliarity with operations and workflows in a Management Services OrganizationAbility to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management.Strong analytical, technical, and troubleshooting skillsDemonstrating flexibility with respect to changing end‐user business needsThe ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help othersThe ability to communicate information clearly and concisely with project leadership and subject matter expertsThe ability to gain trust and establish effective relationships with Epic counterpartsThe ability and willingness to learn new software and systems Listening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracySeeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrenceThe ability to persevere in difficult situations, overcome obstacles, and reach high levels of performance when faced with stressful work situations and time pressuresTapestry Utilization Management:Familiarity with prior authorization requirements, utilization management content, and network structureUnderstanding of authorization policies and procedures that affect the automatic approval or denial of authorizationsKnowledge of areas that integrate with UM or referrals, including scheduling referrals, creating authorizations from orders, and using authorizations to pay claims if installing Tapestry AP ClaimsFamiliarity with operations and workflows in a Management Services OrganizationAbility to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management.Strong analytical, technical, and troubleshooting skillsDemonstrating flexibility with respect to changing end‐user business needsThe ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help othersThe ability to communicate information clearly and concisely with project leadership and subject matter expertsThe ability to gain trust and establish effective relationships with Epic counterpartsThe ability and willingness to learn new software and systemsListening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracy Seeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrenceThe ability to persevere in difficult situations, overcome obstacles, and reach high levels of performance when faced with stressful work situations and time pressuresRequired ExperienceTapestry Core Analyst l:Required:Bachelor’s degree or a license/certification in a clinical specialty with 3 years of experience and underMinimum 4 years of experience will be accepted in lieu of the required degree or diploma Preferred:External applicants must possess active Epic certification in the required application/module at the time of hire with proof of current certificationCertification, experience, or proficiency in one or more of the following Epic modules: Tapestry Managed Care AdministrationExperience working in a Management Services OrganizationTapestry Membership Analyst l:Required:Bachelor’s degree or a license/certification in a clinical specialty 3 years of experience and underMinimum 4 years of experience will be accepted in lieu of the required degree or diplomaPIH Health internal applicants or Altera employees (working at PIH Health as of May 2025), Epic certification in the required application/module must be obtained within 120 days of hire or transfer into the position. Failure to obtain certification within this timeframe may result in removal from the position; however, the employee will be eligible to apply for other internal openings for which they meet the minimum qualifications. External applicants must possess active Epic certification in the required application/module at the time of hire. Proof of current certification is required. Preferred:Certification, experience, or proficiency in one or more of the following Epic modules: Tapestry Managed Care AdministrationExperience working in a Management Services Organization Tapestry Utilization Management Analyst l:Required:Bachelor’s degree or a license/certification in a clinical specialty with 3 years of experience and underMinimum 4 years of experience will be accepted in lieu of the required degree or diplomaPIH Health internal applicants or Altera employees (working at PIH Health as of May 2025), Epic certification in the required application/module must be obtained within 120 days of hire or transfer into the position. Failure to obtain certification within this timeframe may result in removal from the position; however, the employee will be eligible to apply for other internal openings for which they meet the minimum qualifications. External applicants must possess active Epic certification in the required application/module at the time of hire. Proof of current certification is required. Preferred:Certification, experience, or proficiency in one or more of the following Epic modules: Tapestry Managed Care AdministrationExperience working in a Management Services Organization Minimum Salary$102,481.00Maximum Salary$169,104.00

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