Role: Epic Reporting Program Manager (Financial & Quality Analytics)
Location: Redwood City, CA (Hybrid – Onsite 1–2 days/week)
Duration: 6+ months
Pay Rate: $90 to $100
Description: This position is responsible for guiding all technical work required to produce Quality Incentive Pool (QIP) Reporting and all Financial Reporting. We are seeking an individual with strong organizational skills who can lead/mentor technical staff, especially in Epic data modeling. This position is expected to leverage Epic’s best practices and mentor other staff. Additionally, they should be able to validate metric results and assist in troubleshooting when issues arise. Being familiar with QIP metrics is a benefit, but not required, if the candidate has worked with other healthcare metrics, such as HEDIS. The applicant must be fluent in SQL and comfortable working with MS SQL Server and Snowflake.
Duties:
Technical Program Manager for QIP Reporting
- Liaison between Clinical Quality staff and SQL report writers
- SDLC management for Quality Metrics
- Validation of QIP Metrics
- Coordinating data flow to the Quality team for improvement efforts
- Preparation of QIP Reports for submitting to the State
Technical Program Manager for Financial Reporting
- Liaison between Epic BIDs and Finance Staff
- Manage and prioritize regulatory reporting tasks and schedule
- Manage and prioritize reporting requests from Finance Staff
- Architect collection of Financial Daily, Monthly, and Yearly reporting
Epic Billing Expertise (Professional Billing and Hospital Billing)
- Provide expert guidance on Epic PB and HB workflows, configuration, and revenue cycle optimization.
- Assess and refine end-to-end charge capture, coding, claim generation, edits, remittances, and payment posting processes within Epic.
- Troubleshoot complex PB/HB issues including charge router errors, account workqueues, claim edits, duplicate charges, coverage validation, and statement processing.
- Partner with operational stakeholders to streamline front-end and back-end billing workflows, ensuring compliance with regulatory, billing, and reimbursement standards.
- Review and validate build such as charge description master (CDM) updates, charging workflows, fee schedules, benefits determination, and payer configuration.
- Support reporting and analytics for PB/HB functions, including performance dashboards, KPI monitoring, and denial trend analysis.
Must have one or more of the following Certificates:
- Epic Cogito
- Epic Hospital Billing (HB)
- Epic Professional Billing (PB)
- Epic Clarity Data Model
- Epic Revenue Data Model
- Epic Cogito Tools Administration
Familiarity with Innovaccer, Cerner DSS, or eCW is a plus.
