Job Description

Utilization Management RN(Remote)

Interview:Phone+Skype

Job Description:

I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/2026 through 12/30/2026 (extensions possible based on project timelines), 40 hours/week, with schedule options of Monday Friday or Friday Monday (10-hour shifts). Working fully remote in EST hours.

This position will be reviewing prior authorization requests, assessing medical necessity and benefit coverage, and rendering approval decisions across Medicaid, Medicare, and Commercial lines of business. Requires an active Massachusetts RN license, 2-4 years of UM experience, 2-4 years of managed care experience, and InterQual experience across inpatient, post-acute, and outpatient services. Epic experience is a plus.

Please share answer to the following:

1. Do you hold an active, unrestricted Massachusetts RN license?
2. How many years of Utilization Management experience do you have, and how many years of managed care experience specifically?
3. Do you have InterQual experience across inpatient, post-acute, and outpatient services? Please describe your experience applying InterQual criteria for medical necessity determinations.
4. Which lines of business have you worked with (Medicaid, Medicare, Commercial), and do you have any experience with Epic?

Himanshu Goswami

Sr. IT Technical Recruiter

Stellent IT Phone : 3217856032

Email: Himanshu.goswami @stellentit.com

Gtalk: Himanshu.goswami om

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