Job Overview:
Lead the architecture and solution design of EPIC Tapestry capabilities while supporting key healthcare and insurance operational functions. This role drives system enhancements, workflow optimization, and technical integrations across enterprise payer, financial, and third-party systems.
Responsibilities:
- Lead the architecture and solution design of EPIC Tapestry capabilities, including member enrollment and eligibility, benefits and plan administration, claims processing and adjudication, provider network management, utilization management, billing, and customer relationship management.
- Analyze business requirements and translate them into scalable, secure, and compliant technical designs, user stories, acceptance criteria, data flows, and integration specifications.
- Plan, configure, test, and deploy EPIC upgrades, enhancements, and new functionality to support healthcare and insurance operations.
- Design and manage integrations between EPIC and payer, financial, and third-party systems using HL7, FHIR, EDI, and other healthcare interoperability standards.
- Evaluate clinical, administrative, and insurance workflows, identify improvement opportunities, and optimize system performance, efficiency, and regulatory compliance.
- Facilitate requirements and design workshops with business analysts, product managers, Scrum Masters, subject matter experts, clinical teams, administrative teams, and project squads.
- Support unit, integration, and user acceptance testing; troubleshoot complex issues and ensure solutions meet functional, performance, security, and quality requirements.
- Maintain comprehensive architecture, configuration, workflow, data mapping, and support documentation throughout the project lifecycle.
- Provide expert guidance on HIPAA compliance, healthcare data security, and organizational architecture standards.
- Mentor team members, deliver knowledge-transfer sessions, and contribute to sprint and Program Increment planning in Agile or SAFe delivery environments.
- Deliver payer-provider integration initiatives.
- Coach junior analysts and deliver EPIC training and knowledge-transfer sessions.
Requirements:
- Strong knowledge of health insurance operations, including eligibility, benefits, claims, billing, prior authorization, provider networks, and revenue-cycle processes.
- Hands-on understanding of EPIC configuration, electronic claims processing, EDI transactions, HL7, FHIR, and enterprise system integrations.
- In-depth knowledge of HIPAA, healthcare compliance, data privacy, and security requirements.
- Experience working in Agile or SAFe delivery environments.
- Familiarity with JIRA or comparable tools for backlog, project, and issue management.
- Strong analytical, troubleshooting, documentation, and problem-solving skills.
- Strong verbal and written communication skills, with the ability to explain technical concepts to both technical and non-technical stakeholders.
Benefits:
Our Benefits Include:
- Medical, Dental, and Vision Insurance
- 401(k) Retirement Plan
- Health Savings Account (HSA)
- Disability Insurance (Short-Term and Long-Term)
- Life and AD&D Insurance
- Paid Sick Leave (where required by applicable state or local law)
- Supplemental Insurance Plans
- Identity Theft Protection
- Pet Insurance
- Employee Wellness Programs
- Employee Assistance Program (EAP)
- Career Growth and Professional Development Opportunities
Disclaimer: Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Systems Inc. reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.
About Cynet Systems
Founded in 2010 and headquartered in the Washington, DC metro area, Cynet Systems Inc. is a leading technology staffing and workforce solutions company serving Fortune 500 companies, government agencies, and enterprise organizations across the United States and Canada. We deliver agile, scalable talent solutions across IT, engineering, life sciences, clinical, and professional staffing, powered by a high-performing recruitment engine operating across North America and Asia.
As a nationally and locally certified Minority Business Enterprise (MBE), Cynet Systems is committed to helping organizations build high-performing teams while empowering professionals to grow rewarding careers. Our organization is certified to ISO 9001, ISO 14001, ISO 27001, and SOC 2 Type II standards, reflecting our commitment to quality, security, operational excellence, and customer success.