Little Rock, AR, USA+1 moreMore locations: Arkansas, USA
HybridFlex work arrangement; routine campus travel within walking distance of the primary work assignment.
IT OperationsEnterprise Applications
About the job
Requirements
A bachelor's degree in Business, Healthcare, Nursing, Health Administration, Computer Science, or a related field is required; five years of related experience may be substituted for the degree in addition to the experience requirements.
At least five years of experience in healthcare information technology, health plan operations, or clinical data exchange is required.
Experience with healthcare data standards and interoperability concepts such as FHIR and HL7 is required.
Experience analyzing data quality, mapping, and system performance to drive process improvements is required.
Knowledge of payer-provider workflows, including prior authorization, claims, care management, and quality reporting such as HEDIS, is required.
Ability to work with external provider organizations and vendors to support integrations and data exchange is required.
Responsibilities
Collaborate with internal stakeholders and vendors on system enhancements, upgrades, and adoption of new features.
Configure and support Epic Payer Platform applications to enable payer-provider interoperability.
Develop and maintain documentation, workflows, and training materials for end users.
Ensure timely and accurate data exchange to support risk adjustment, care gap closure, quality measurement such as HEDIS, and development of member longitudinal health records.
Evaluate system performance, monitor data quality and mapping, and identify opportunities to improve operational efficiency, reduce administrative burden, and enhance provider engagement.
Identify and implement process improvements to enhance efficiency and reduce administrative burden.
Use reporting and analytics to monitor performance, identify trends, and support decision-making.
Monitor and ensure data quality, accuracy, and appropriate mapping across systems.
Partner with internal stakeholders, vendors, and provider teams to troubleshoot issues, support system enhancements, and drive adoption of Payer Platform capabilities that improve interoperability, streamline processes, and enable data-driven decision-making to improve member outcomes.
Partner with providers to onboard, test, and optimize Payer Platform integrations and workflows.
Troubleshoot application, integration, and workflow issues across payer and provider environments.
To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.
Job Summary
The Epic Payor Platform Applications Analyst/Health Data Management Exchange Analyst collaborates with internal business and technical teams, as well as external provider organizations, to support the implementation, configuration, and optimization of Epic Payer Platform applications. This role enables and maintains bidirectional exchange of clinical and administrative data between the health plan and provider partners, supporting workflows such as clinical data exchange, prior authorization, claims, and other Payer Platform capabilities.
Requirements
EDUCATION
Bachelor’s degree in Business, Healthcare, Nursing, Health Administration, Computer Science, or related field. In lieu of degree, five (5)
years' related experience will be considered in addition to the experience requirements listed below.
EXPERIENCE & KNOWLEDGE
Minimum five (5) years experience in healthcare Information Technology (IT), health plan operations, or clinical data exchange required.
Experience with healthcare data standards and interoperability concepts (e.g., FHIR, HL7).
Experience analyzing data quality, mapping, and system performance to drive process improvements.
• Collaborates with internal stakeholders and vendors on system enhancements, upgrades, and new feature adoption.
• Configures and supports Epic Payer Platform applications to enable payer-provider interoperability.
• Develops and maintains documentation, workflows, and training materials for end users.
• Ensures timely and accurate data exchange to support risk adjustment, care gap closure, quality measurement (e.g., HEDIS), and the development of member longitudinal health records.
• Evaluates system performance, monitors data quality and mapping, and identifies opportunities to improve operational efficiency, reduce administrative burden, and enhance provider engagement.
• Identifies and implements process improvements to enhance efficiency and reduce administrative burden.
• Leverages reporting and analytics to monitor performance, identify trends, and support decision-making.
• Monitors and ensures data quality, accuracy, and appropriate mapping across systems.
• Partners with internal stakeholders, vendors, and provider teams to troubleshoot issues, support system enhancements, and drive adoption of Payer Platform capabilities that improve interoperability, streamline processes, and enable more effective, data-driven decision-making to improve member outcomes.
• Partners with providers to onboard, test, and optimize Payer Platform integrations and workflows.
• Troubleshoots application, integration, and workflow issues across payer and provider environments.
Certifications
Hiring Range
$69,600.00 - $91,400.00
Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
Employment Type
Regular
ADA Requirements
1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.