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Cigna Clinical Review Jobs (NOW HIRING)

Sagility

Cigna EHE Health Coach

Concord, NC · Remote

$24/hr

Cigna EHE Health Coach We are currently hiring a talented LPN/LVN, Cigna Everyday Health Engagement ... Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in ...

Cigna

Medical Director - Pathology - EviCore

... Cigna Group, you'll leverage your background in pathology-including Anatomic Pathology, Clinical ... Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on ...

Cigna

Medical Director - Pathology - EviCore

... Cigna Group, you'll leverage your background in pathology-including Anatomic Pathology, Clinical ... Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on ...

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Cigna Clinical Review information

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$14

$34

$90

How much do cigna clinical review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for cigna clinical review in the United States is $34.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $32.93 per hour, depending on experience, location, and employer.

What is the difference between Cigna Clinical Review vs Cigna Medical Reviewer?

AspectCigna Clinical ReviewCigna Medical Reviewer
CredentialsTypically requires clinical certifications (e.g., RN, MD)Requires medical licenses and clinical certifications
Work EnvironmentHealthcare insurance review teams, remote or office-basedHealthcare insurance review teams, remote or office-based
Employer & Industry UsageInsurance companies, healthcare providersInsurance companies, healthcare providers
Primary RoleAssess medical necessity for insurance claimsEvaluate medical records and determine coverage eligibility

Both roles involve reviewing medical information within insurance settings, often requiring similar clinical credentials. The main difference is that Cigna Clinical Review focuses on assessing medical necessity, while Cigna Medical Reviewer evaluates medical records for coverage decisions. Both positions are integral to insurance healthcare teams and share similar work environments.

What are the key skills and qualifications needed to thrive as a Cigna Clinical Review specialist, and why are they important?

To thrive as a Cigna Clinical Review Specialist, you need a robust clinical background, usually as a registered nurse or allied health professional, with experience in case management or utilization review. Proficiency in healthcare management software, electronic medical records (EMRs), and familiarity with industry-standard guidelines like InterQual or MCG are typically required. Exceptional attention to detail, critical thinking, and strong communication skills set top performers apart in this role. These competencies ensure accurate, timely reviews that support patient care and regulatory compliance within managed healthcare environments.

How does a Cigna Clinical Review professional typically work with healthcare providers to assess patient care plans?

As a Cigna Clinical Review professional, you'll frequently interact with healthcare providers to evaluate and approve patient care plans and treatment requests. This involves reviewing clinical documentation, applying evidence-based guidelines, and sometimes discussing case details directly with physicians or nurses to clarify information or recommend alternatives. Collaboration and clear communication are vital, as your input impacts patient outcomes and provider satisfaction. You will often work as part of an interdisciplinary team, balancing medical necessity with policy requirements to ensure quality care for members.

What is a Cigna Clinical Review?

A Cigna Clinical Review is a process where medical professionals evaluate healthcare services, treatments, or medications to determine if they are medically necessary and covered under a member’s health insurance plan. This review helps ensure that patients receive appropriate care based on clinical guidelines and the terms of their insurance policy. The process may involve reviewing medical records, consulting with healthcare providers, and applying evidence-based criteria to make coverage decisions.
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Cigna Clinical Review jobs near you
Infographic showing various Cigna Clinical Review job openings in the United States as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 100% In-person job distribution, with an average salary of $72,002 per year, or $34.6 per hour.

Cigna EHE Health Coach

Sagility

Concord, NC • Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Sagility rating

4.6

Company rating: 4.6 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

62nd of 71 rated call and contact centers

Job description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Cigna EHE Health Coach

Job Description:

We are currently hiring a talented LPN/LVN, Cigna Everyday Health Engagement Coach. Coaches provide education on Chronic Conditions, Health and Wellness, and Lifestyle Management Programs. They work with customers 1 on 1, over the phone to establish health improvement plans, set personalized goals, and support customers in achieving those goals through behavior changes to improve health status, reduce health risks, and improve quality of life. The LPN/LVN Engagement coach has a key role in ensuring the member will maintain a healthy lifestyle while in the community. Successful candidates must hold a valid, current license issued by the state in which the candidate resides.

Key responsibilities:

  • Establish health improvement plans based on member specifications
  • Establish personalized goals
  • Support customers in achieving those goals through behavior changes to improve health status
  • Work with customers to reduce health risks and improve quality of life
  • Communicates results of reviews verbally, in the medical record, and through official written notification to the primary care team, specialty providers, care managers, vendors and members in adherence with regulatory and contractual requirements
  • Provides decision-making guidance to clinical teams on service planning as needed
  • Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in accordance with Standard Operating Procedures
  • Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy
  • Works with Manager and other clinical leadership to ensure that departmental and organizational policies and procedures as well as regulatory and contractual requirements are met
  • Additional duties as requested by supervisor
  • Maintains knowledge of CMS and State regulatory requirements

Education Requirements:

  • Associate's degree required,
  • LPN/LVN- you must hold a valid, current license issued by the state in which the candidate resides

Desired Experience (nice to have):

  • Customer experience
  • Remote work experience
  • Proficient with Microsoft Teams and Office.

Required Knowledge, Skills & Abilities (must have):

  • Ability to complete assigned work in a timely and accurate manner
  • Ability to work independently

Desired Knowledge, Skills, Abilities & Language (nice to have):

  • Flexibility and understanding of individualized care plans
  • Ability to influence decision making
  • Strong collaboration and negotiation skills
  • Strong interpersonal, verbal, and written communication skills
  • Comfort working in a team-based environment
  • Knowledge of Medicare and Mass health services and benefits

Hourly wage $24.00

Hours: Monday through Friday 7AM to 8PM Central Time

This is a fully remote work at home role. You must have a secure, private wok at home area with a hardwired internet connection with speeds greater than 5MB upload and 10MB download.

Sagility Offers Competitive Benefits Including:

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Short-Term and Long-Term Disability
  • Flexible Spending Account
  • Life Assistance Program
  • 401K with employer contribution
  • PTO and Sick Time
  • Tuition Reimbursement

Join our team, we look forward to talking with you!

An Equal Opportunity Employer/Vet/Disability

Location:

Work@Home USAUnited States of America

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