EPIC Solution Design Consultant at HCLTech

HCLTech is looking for a highly talented and self-motivated EPIC Solution Design Consultant to join it in advancing the technological world through innovation and creativity. Job Title: EPIC Solution Design ConsultantJob ID: 2798504Position Type: Full-timeLocation: Pleasanton, CA(Remote)Role/Responsibilities Responsible for designing, analyzing, and implementing innovative solutions that strategically align with complex business requirements. This role demands deep expertise in EPIC systems, health insurance workflows, and integration methodologies to create seamless, secure, and compliant operations across both clinical and administrative systems.Lead the design and architecture of the Epic Claims modules, including Resolute Professional Billing (PB) and Hospital Billing (HB), focusing on claims, billing, and accounts receivable workflows.Plan, configure, test, and implement Epic software updates and new functionality, translating complex business requirements into practical system solutions.Collaborate with clinical and administrative leadership to perform workflow analysis, identify areas for improvement, and optimize system use to enhance efficiency and ensure regulatory compliance.Design and manage integrations between Epic and third-party systems related to claims submission, payment processing, and other financial operations.Provide expert-level support, including troubleshooting complex technical issues and working with end-users to resolve system problems.Mentor junior analysts and team members and ensure comprehensive technical and support documentation is created and maintained. Analyze business requirements and translate them into scalable, secure, and compliant solution designs for healthcare and insurance domains.Configure and optimize EPIC system workflows to support health insurance processes, including eligibility, claims management, billing, and prior authorization.Ensure interoperability between EPIC modules and external payer systems, utilizing standards such as HL7, FHIR, and EDI for robust data exchange.Collaborate with business analysts, project managers, and technical teams to validate requirements and design effective solutions.Facilitate workshops with clinical, administrative, and payer stakeholders to gather insights and continuously improve workflows.Configure EPIC modules (e.g., Tapestry, Resolute, Benefits Engine) for insurance-related functionalities and support integration strategies for claims processing, eligibility verification, and premium billing.Provide expert guidance on HIPAA compliance and data security best practices throughout solution design and implementation.Develop comprehensive solution design documentation, including data flow diagrams and integration specifications, maintaining compliance with organizational architecture standards and regulatory requirements.Support and participate in system testing (unit, integration, user acceptance) to validate that solutions meet functional and performance criteria prior to deployment.Deliver knowledge transfer and training sessions to internal teams on EPIC configurations and insurance workflows.Act as a subject matter expert for troubleshooting and optimization, leading detailed design efforts and workflow planning within project squads.Translate complex business requirements into clear, actionable technical specifications and contribute to user story creation, ensuring acceptance criteria are well-defined.Develop and maintain design documentation, updating regularly throughout the project lifecycle to ensure accuracy and completeness.Collaborate with technical SMEs to provide necessary details for successful completion of development stories.Lead design and technical discussions across squads and teams to ensure alignment, integration, and successful project outcomes.Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning and work closely with other squads to define feature strategies for projects and initiatives.Qualifications & Experience A bachelor’s degree in healthcare management, Information Technology, or a related field, or equivalent experience is typically required. Active Epic certification(s) in relevant Revenue Cycle modules (e.g., Resolute PB, Resolute HB, Claims, Tapestry) is required.Minimum Requirements5+ years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting.Active Epic certification(s) in relevant Revenue Cycle modules (e.g., Resolute PB, Resolute HB, Claims, Tapestry) is required.In-depth knowledge of healthcare revenue cycle operations, electronic claims processing standards (e.g., EDI, specific claim forms), system integration standards such as HL7 & FHIR, and system configuration. Strong analytical and problem-solving skills are essential.Excellent communication skills, with the ability to work closely with multidisciplinary teams and translate technical concepts into actionable insights for non-technical stakeholders.Strong understanding of health insurance processes, including eligibility, claims, billing, and prior authorization.In-depth knowledge of HIPAA and healthcare compliance regulations.Experience with payer-provider integration projects.Exposure to project management methodologies, particularly Agile or SAFe.Familiarity with JIRA for project tracking and issue management.Pay and Benefits Pay Range Minimum: $ 74000 per year Pay Range Maximum: $ 151800 per year HCLTech is an equal opportunity employer, committed to providing equal employment opportunities to all applicants and employees regardless of race, religion, sex, color, age, national origin, pregnancy, sexual orientation, physical disability or genetic information, military or veteran status, or any other protected classification, in accordance with federal, state, and/or local law. Should any applicant have concerns about discrimination in the hiring process, they should provide a detailed report of those concerns to [email protected] for investigation.Compensation and BenefitsA candidate’s pay within the range will depend on their work location, skills, experience, education, and other factors permitted by law. This role may also be eligible for performance-based bonuses subject to company policies. In addition, this role is eligible for the following benefits subject to company policies: medical, dental, vision, pharmacy, life, accidental death & dismemberment, and disability insurance; employee assistance program; 401(k) retirement plan; 10 days of paid time off per year (some positions are eligible for need-based leave with no designated number of leave days per year); and 10 paid holidays per year.How You’ll GrowAt HCLTech, we offer continuous opportunities for you to find your spark and grow with us. We want you to be happy and satisfied with your role and to really learn what type of work sparks your brilliance the best. Throughout your time with us, we offer transparent communication with senior-level employees, learning and career development programs at every level, and opportunities to experiment in different roles or even pivot industries. We believe that you should be in control of your career with unlimited opportunities to find the role that fits you best.