Solutions Manager (EMR Workflow Design)

Humata Health is seeking a Solutions Manager with deep Epic workflow expertise to join our Customer Success team. This is a hybrid individual contributor and people leadership role. You will be the strategic workflow design partner for health system customers, translating clinical and operational requirements into optimized EMR configurations that seamlessly integrate with Humata’s prior authorization automation platform. You will also lead a growing team of solution engineers and workflow consultants.

This is not a traditional technical integration role—we have Solutions Engineers who handle EDI, APIs, and connectivity. You'll own the workflow design layer: how authorization requests flow through Epic, what clinical data gets aggregated, how staff interact with the system, and how customers should configure Epic to maximize automation and minimize provider burden.

Location: Remote - USA

• Design end-to-end prior authorization workflows within Epic that integrate with Humata's automation platform, including:

  • Referral-based workflows (278R transaction triggers from Orders, Referrals, or Scheduled Appointments)

  • BPA (Best Practice Advisory) / CDS configurations for real-time authorization checks

  • In Basket routing for authorization status updates and pended requests

  • Integration with Epic Cadence (scheduling) and Grand Central (registration/ADT) for coverage verification

• Own the workflow configuration strategy, determining:

  • Which clinical events should trigger authorization requests

  • What clinical data elements need to be aggregated and mapped

  • How customers should approach workflow segmentation in workqueues

  • How to route tasks between schedulers, authorization specialists, and providers

  • Where Humata's automation fits into existing Epic workflows vs. where Epic-native tools should be used

• Design clinical data aggregation strategies to support medical necessity determinations:

  • Problem List, Medications, Lab Results, Imaging Reports

  • Procedure and Diagnosis code mapping from encounter documentation

  • Progress Notes and clinical summary extraction

  • Custom SmartData Elements for payer-specific requirements

• Serve as the primary workflow SME for customer IT, Epic analysts, and clinical operations teams during implementations and expansions

• Lead workflow discovery sessions with health system stakeholders to:

  • Map current-state authorization processes and pain points

  • Identify automation opportunities and workflow optimization strategies

  • Define future-state workflows that balance automation with clinical review requirements

• Engage customer stakeholders on the broader processes that come before and after the prior authorization workflow:

  • Identify risks and propose optimizations that will increase the success and value of an implementation

  • Collaborate with customers on design of future state process improvements, diagramming approaches and supporting change management efforts.

• Provide Epic-specific guidance on:

  • Which Epic modules/tools and people to leverage (Referrals, Orders, Prelude, Cadence, etc.)

  • Configuration options for authorization workflows (Orders vs. Referral-initiated)

  • Build vs. buy decisions for Epic-native functionality

  • Upgrade planning and compatibility with Humata integrations

• Translate complex payer authorization requirements into actionable Epic configuration specifications

• Build and maintain a library of reference workflow designs for common use cases:

  • Outpatient therapy series authorizations (PT/OT/ST)

  • High-cost imaging pre-authorizations (MRI, CT, PET)

  • Specialty pharmacy authorizations

  • Delegated entity workflows (Carelon, Evicore, Prime Therapeutics)

• Create Epic-specific implementation guides including:

  • Build specifications

  • Workqueue best practices

  • BPA configuration examples

  • Staff training materials for authorization workflows

• Document workflow optimization patterns that reduce administrative burden while maintaining compliance

• Partner with Product Management to ensure Humata's platform capabilities align with real-world Epic workflow constraints and opportunities

• Provide feedback on product roadmap priorities based on customer workflow needs

• Identify gaps in current automation capabilities that require new Epic integration points

• Collaborate with Solutions Engineers to ensure workflow designs are technically feasible given integration architecture

Team Leadership & People Management

• You will lead a team responsible for Epic workflow design and directly manage Solutions Engineers and Workflow Consultants

• Coach team members on Epic design best practice and consulting skills

• Provide performance feedback, coaching and career development

• Hire and onboard new team members as the team scales

• 5+ years of hands-on Epic experience, with at least 3 years in one or more of the following areas:

  • Epic implementation/optimization consulting (preferably Revenue Cycle or Ambulatory)

  • Epic application analyst role (Referrals, Orders, Cadence, Prelude, or Grand Central)

  • Epic workflow development and configuration

• Direct experience with Epic prior authorization workflows, including:

  • Understanding of how 278 transactions map to Epic data elements

  • Configuration of authorization request triggers and routing

  • Integration between Epic and payer portals or clearinghouses

  • Staff workflows for authorization submission, tracking, and follow-up

• Deep knowledge of Epic's technical architecture for workflow design:

  • Epic workflows and configuration (Chronicles backend logic, rules, and triggers)

  • Clinical data capture tools

  • BPA configuration and logic

  • In Basket message routing and task management

  • Report writing for workflow monitoring (Clarity/Caboodle)

• Strong understanding of healthcare operations:

  • Revenue cycle workflows (scheduling, registration, authorization, billing)

  • Utilization management and medical necessity requirements

  • Payer-provider interactions and common authorization pain points

  • HIPAA compliance in workflow design

• Leadership and management experience

  • Prior experience leading or mentoring analysts, consultants or technical team members

  • Comfortable serving as an escalation point and advisor to team members to unblock challenges

  • Can balance strategic planning, hands-on design and people management in a hybrid role

• Epic certification(s) in relevant modules (Referrals, Resolute HB, Cadence, Prelude, or Orders)

• Former Epic employee (especially from Revenue Cycle, Resolute HB, Referrals, or Cadence teams), with no remaining non-competition constraints

• Experience working with delegated review entities (Carelon/Evicore/Prime) and their Epic integrations

• Exposure to RPA tools or automation platforms

• Experience with SMART on FHIR or other interoperability frameworks

• Familiarity with series authorization workflows for therapy services (PT/OT/ST)

• Experience training or mentoring Epic analysts or clinical staff

• Understanding of payer portal navigation and manual authorization processes

• Ability to translate clinical and operational requirements into Epic-specific technical designs

• Strong communication skills for both technical (Epic analysts) and non-technical (clinical operations) audiences

• Systems thinking: understanding how workflow changes in one Epic module cascade to others

• Customer-facing consulting skills with ability to build trust and credibility with health system leaders

• Thoughtful and approachable leader who can lead a high-performing team

• Pragmatic problem-solving: balancing ideal workflows with real-world constraints

• Self-directed learner who stays current on Epic updates and healthcare authorization trends

🚀 Why Join Humata Health?

• Impactful Work: Contribute to innovative solutions that improve healthcare efficiency and patient outcomes

• Remote Flexibility: Enjoy working remotely while being part of a collaborative team, with access to our new office in Winter Park, FL

• Competitive Compensation: Enjoy competitive base compensation, equity through our Employee Stock Option Plan, and bonus-eligible roles

• Comprehensive Benefits: Full benefits package including unlimited PTO and 401k program with employer match

• Growth Opportunities: Advance your career in a fast-paced, high-impact environment with ample professional development

• Inclusive Culture: Join a diverse workplace where your ideas and contributions are valued

-

Pay Transparency

Humata Health will provide pay transparency information upon application to those in qualifying jurisdictions.

Our salary ranges are based on competitive pay for our company’s size and industry. They are one part of the total compensation package that may also include equity, variable compensation, and benefits.  Individual pay decisions are ultimately based on several factors, including qualifications, experience level, skillset, geography, and balancing internal equity.

-

Humata Health is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, age, sex, marital status, ancestry, neurotype, physical or mental disability, veteran status, gender identity, sexual orientation or any other category protected by law.

-

Join us in our mission to transform healthcare while building a life that works in harmony both in and outside the office.