EPIC Tapestry Systems Quality Analyst - Remote

Posted 45 Minutes Ago
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Hiring Remotely in Eden Prairie, MN, USA
In-Office or Remote
73K-130K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Configures and quality-tests Epic payer operations applications supporting claims, eligibility, benefits, contracts, provider setup, and payments. Translates healthcare contracts and business requirements into system builds and rules, validates processing, resolves issues, supports implementations and upgrades, and maintains documentation and audit evidence. Partners with operational, technical, client, vendor, and project stakeholders while ensuring regulatory and business alignment. Requires Epic certification, healthcare payer experience, advanced Excel skills, and up to 10% travel.
Summary Generated by Built In
Requisition Number: 2380519
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
This role sits at the intersection of healthcare operations and technology. The Epic Information Systems Quality Analyst interprets payer and provider contract requirements, translates those requirements into Epic system configuration and business rules, and validates that builds process accurately. The role supports risk operations across eligibility, claims, benefits, contracts, provider setup, accounts payable, and payments, with a solid emphasis on quality, documentation, compliance, and successful implementation.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
  • Review payer and provider contracts, reimbursement terms, and healthcare business requirements; break complex content into detailed system and operational requirements
  • Configure and maintain Epic application builds and business rules supporting claims, eligibility, benefits, contracts, provider setup, payments, and related payer operations
  • Perform quality assurance reviews of application builds to verify that configuration is accurate and transactions are processing as intended
  • Identify build or processing issues, coordinate corrective action and retroactive claims reprocessing when needed, and support process improvements that reduce recurrence
  • Support new features, upgrades, new health plans, new payers, benefit plans, and member implementations from requirements through go-live readiness
  • Develop and maintain build documentation, test evidence, quality audit materials, process documentation, and implementation records
  • Partner with business operations, IT, project teams, health plans, vendors, clients, and other internal stakeholders to support successful delivery
  • Help ensure solutions align with applicable regulatory, health plan, client, and operational requirements
  • Use Microsoft Excel for reporting, tracking, contract analysis, validation, and organization of detailed requirements

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Current or Epic certification in at least one Epic application or module. The certification may be active or inactive and does not need to be in Epic Tapestry
  • 3+ years of experience supporting Epic applications through configuration, build, systems analysis, testing, quality assurance, issue resolution, implementation, upgrades, or production support
  • 3+ years of experience in healthcare payer operations, managed care, health plan operations, claims, eligibility, benefits, contract administration, provider reimbursement, or a closely related healthcare business environment
  • Experience interpreting complex healthcare business requirements, payer contracts, provider contracts, reimbursement terms, or business rules and translating them into system configuration, workflows, or technical requirements
  • Experience reviewing, validating, testing, auditing, or quality-checking system configuration, application builds, business rules, or operational processes
  • Intermediate to advanced Microsoft Excel skills for analysis, reporting, tracking, reconciliation, or requirements validation
  • Demonstrated ability and willingness to obtain or reactivate role-specific Epic certifications after hire, based on business needs and training availability. The hiring team anticipates completion within approximately one year
  • Demonstrated solid analytical skills and attention to detail, including the ability to break complex information into logical components and evaluate whether system outcomes align with requirements
  • Ability to travel up to 10%, primarily as needed for Epic training or certification

Preferred Qualifications:
  • Epic Tapestry experience or certification
  • Epic certification or hands-on experience in Contracts, Eligibility, Benefits, Claims, or related payer workflows
  • Experience with healthcare payer configuration, claims adjudication, contract implementation, provider reimbursement, or payment operations
  • Experience performing root cause analysis and resolving complex application or operational issues.
  • Experience supporting system upgrades, new functionality, implementations, testing cycles, or go-live activities
  • Experience coordinating retroactive claims correction or reprocessing
  • Experience creating build documentation, quality audit records, test scenarios, or implementation documentation
  • SQL experience or experience using comparable data-analysis and reporting tools
  • Demonstrated ability to communicate effectively with technical and nontechnical stakeholders and to explain detailed business and system information clearly

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • Current or inactive Epic certification in at least one Epic application or module
  • At least 3 years of experience supporting Epic applications through configuration, build, systems analysis, testing, quality assurance, issue resolution, implementation, upgrades, or production support
  • At least 3 years of experience in healthcare payer operations, managed care, health plan operations, claims, eligibility, benefits, contract administration, provider reimbursement, or a related healthcare business environment
  • Experience interpreting healthcare business requirements, payer contracts, provider contracts, reimbursement terms, or business rules and translating them into system configuration, workflows, or technical requirements
  • Experience reviewing, validating, testing, auditing, or quality-checking system configuration, application builds, business rules, or operational processes
  • Intermediate to advanced Microsoft Excel skills for analysis, reporting, tracking, reconciliation, or requirements validation
  • Ability and willingness to obtain or reactivate role-specific Epic certifications after hire, anticipated within approximately one year
  • Solid analytical skills and attention to detail, including breaking complex information into logical components and evaluating system outcomes
  • Ability to travel up to 10%, primarily for Epic training or certification
  • Epic Tapestry experience or certification
  • Epic certification or hands-on experience in Contracts, Eligibility, Benefits, Claims, or related payer workflows
  • Experience with healthcare payer configuration, claims adjudication, contract implementation, provider reimbursement, or payment operations
  • Experience performing root cause analysis and resolving complex application or operational issues
  • Experience supporting system upgrades, new functionality, implementations, testing cycles, or go-live activities
  • Experience coordinating retroactive claims correction or reprocessing
  • Experience creating build documentation, quality audit records, test scenarios, or implementation documentation
  • SQL experience or experience using comparable data-analysis and reporting tools
  • Ability to communicate effectively with technical and nontechnical stakeholders and explain detailed business and system information clearly

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Parental & Family Support Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
  • Retirement Support A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
  • Equity Value & Accessibility An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
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Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
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Houston, TX
Hyderabad, India
Jacksonville, FL
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Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
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Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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