Job Title

Location : Remote Position Summary: 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 stewards secure, reliable data exchange and workflows between payer systems and Epic enabled provider organizationscovering eligibility, coverage discovery, prior authorization, claims status, clinical data retrieval, and care gap closure. You will manage operational runbooks, environment readiness, connectivity, security, and incident response and drive continuous improvement across FHIR/EDI integrations and Epic interfaces. Key Responsibilities: Platform Administration & Operations Support the 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. Integration & Data Exchange 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 lifecycles and client registrations. Support EDI/X12 transactions (270/271 eligibility, 276/277 claim status, 278 prior auth, 834 enrollment where applicable, 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. Incident, Problem & Performance Management 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. Stakeholder Engagement & Enablement Coordinate with Epic TS/Customer Support, vendor partners, and provider IT teams for change windows, go lives, and escalations. Drive adoption of best practices. Continuous Improvement 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). Required Qualifications: 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. Preferred Qualifications: 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. Core Competencies: 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. Important note: The client is open to considering candidates with backgrounds as Business Analyst, Business Systems Analyst, or Systems Analyst, provided they have strong experience in the healthcare payer/health plan domain and a solid understanding of healthcare interoperability and payer platform fundamentals. Experience with Epic is a plus, but not mandatory. What''s essential is a demonstrated willingness and eagerness to learn the Epic Payer Platform on the job, as this will be a key focus during the interview process.