Senior UM Nurse – Remote Medical Necessity & Compliance
Los Angeles, Los Angeles County, California, 90001, USA
Listed on 2026-10-26
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Nursing
Healthcare Nursing
TALENT Software Services is seeking a Senior Utilization Management Nurse in California to review post-service claims for medical necessity and evaluation against contract language. The role requires strong clinical judgment and in-depth knowledge of UM processes, DRG validation, and hospital billing standards.
You will audit line-by-line itemizations, collaborate with Medical Directors, and communicate decisions to providers and members while ensuring compliance with state and accreditation
This Full Time opening is for the Senior UM Nurse – Remote Medical Necessity & Compliance role at TALENT Software Services.
Full responsibilities and requirements are described in the listing above.
Learn more about the Senior UM Nurse – Remote Medical Necessity & Compliance role in the description above.
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