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Cigna Rn Remote Jobs in Pennsylvania (NOW HIRING)

Merakey

LumiLink RN

Lafayette Hill, PA · Remote

The Remote LumiLink Registered Nurse is responsible for professionally answering LumiLink calls for health-related concerns for all contracted providers. This position is responsible for the ...

MVP Recovery

PRN Remote CRNP

Chester, PA · On-site +1

$90K - $121K/yr

Flexible | PRN Position Overview MVP Recovery is seeking a Certified Registered Nurse Practitioner (CRNP) to provide follow-up medication management appointments in a PRN, primarily remote capacity.

Corry Manor

RNAC (PT) | Local Remote

Corry, PA · Remote

$29.75 - $38/hr

Overview20 hours Remote -- must reside local to Erie/Crawford County PA A RNAC coordinates the MDS ... Benefits for a MDS RN: * Promotion opportunities * Flexibility * Education/Learning * Competitive ...

HCF of Corry Inc

RNAC (PT) | Local Remote

Corry, PA · Remote

$29.75 - $38/hr

Position Summary: 20 hours Remote -- must reside local to Erie/Crawford County PA A RNAC ... Current license as a Registered Nurse with the State Board of Nursing. CPR certification ...

NOMAD

Travel Nurse - Telemetry $2,016/wk

Scranton, PA · Remote

$2.0K/wk

Nomad offers Registered Nurses a hassle-free experience, industry-leading pay rates, full benefits ... Additional Confirmations Ability to float to Med Surg and remote Tele is required. * Travel ...

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How much do cigna rn remote jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for cigna rn remote in Pennsylvania is $45.02, according to ZipRecruiter salary data. Most workers in this role earn between $34.47 and $53.51 per hour, depending on experience, location, and employer.

What is a Cigna RN Remote job?

A Cigna RN Remote job is a work-from-home nursing position where registered nurses provide telephonic or virtual patient care, case management, or health coaching. Nurses in this role typically assess patient needs, coordinate care plans, and educate members on managing their health conditions. These positions may be in areas like utilization management, disease management, or triage nursing. The job requires an active RN license, clinical experience, and strong communication skills.

What are some typical challenges faced by Cigna RN Remote professionals, and how can they be managed?

Cigna RN Remote professionals often face challenges such as balancing multiple case loads, adapting to limited in-person patient interactions, and maintaining clear communication with both patients and colleagues in a virtual setting. To manage these challenges, it's important to develop strong organizational skills, leverage digital health tools effectively, and proactively participate in virtual team meetings. Continuous learning and regular collaboration with support staff also help remote RNs stay informed and connected. By staying engaged and utilizing available resources, remote nurses can overcome common hurdles and excel in providing patient-centered care from home.

What are the key skills and qualifications needed to thrive in the Cigna Rn Remote position, and why are they important?

To thrive as a Cigna RN Remote, you need an active RN license, strong clinical assessment abilities, and experience in case management or telehealth nursing. Familiarity with electronic health record (EHR) systems, secure communication platforms, and care coordination software is typically required. Excellent time management, self-motivation, and effective virtual communication are key soft skills for this remote position. These competencies are vital for delivering high-quality patient care, maintaining compliance, and efficiently collaborating within a virtual healthcare team.

What are popular job titles related to Cigna Rn Remote jobs in Pennsylvania? For Cigna Rn Remote jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Cigna Rn Remote jobs in Pennsylvania look for? The top searched job categories for Cigna Rn Remote jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Cigna Rn Remote jobs? Cities in Pennsylvania with the most Cigna Rn Remote job openings:
Cigna Rn Remote jobs near you

Remote/Hybrid Registered Nurse (RN) - Advocacy & Program Integrity (Hospice Expert)

The CKHobbie Group

Harrisburg, PA • On-site, Remote

$40 - $42/hr

Full-time

PTO

Posted 10 days ago

Job description

Job Description
Are you a registered nurse ready to take your career in an exciting newdirection-one where your expertise truly makes a difference? JoinPennsylvania's premier Quality Improvement Organization and step into adynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion the needs of vulnerable populations,safeguard the quality of care, and influence healthcare outcomes on ameaningful scale. Enjoy the freedom of working from home, theflexibility and autonomy to manage your workday, and the opportunity forcontinuous professional growth-all while being part of a passionate,mission-driven team dedicated to improving healthcare across theCommonwealth.
Are you a registered nurse ready to take your career in an excitingnew direction-one where your expertise creates real, lasting impact?Join Pennsylvania's premier Quality Improvement Organization and play a vital role in protecting healthcare quality, advocating forvulnerable populations, and ensuring the integrity of criticalhealthcare programs.
In this rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity initiatives, and advocate for beneficiaries across theCommonwealth. You'll enjoy the flexibility of working from home, theautonomy to manage your work, and meaningful opportunities forprofessional growth-all while contributing to a mission that trulymatters.
What You'll Do
  • Conduct clinical reviews and ensure quality, appropriateness, and compliance with healthcare standards
  • Support program integrity efforts by identifying trends, risks, and opportunities for improvement
  • Advocate for beneficiaries, with a strong focus on protecting and improving care for vulnerable populations
  • Apply nursing judgment to analyze medical records, documentation, and billing data
  • Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices
  • Contribute to quality improvement initiatives that strengthen healthcare delivery across Pennsylvania

What We're Looking For
  • Active, unrestricted Registered Nurse (RN) license
  • Strong clinical background with the ability to apply nursing judgment analytically
  • Interest in advocacy, quality improvement, and healthcare program integrity
  • Excellent written and verbal communication skills
  • Ability to work independently while managing multiple priorities
  • Comfort with technology and electronic medical records

Experience in utilization review, case management, quality improvement, compliance, or claims review is a plus-but not required.
Why Join Us
  • Mission-driven work with Pennsylvania's leading Quality Improvement Organization
  • Make a real impact on healthcare quality and outcomes for vulnerable populations
  • Remote work - enjoy the convenience and balance of working from home
  • Autonomy and flexibility in how you manage your workday
  • Advocacy-focused role that values your nursing voice and expertise
  • Career development opportunities to grow beyond traditional nursing roles
  • Supportive, collaborative team culture committed to excellence and integrity

If you're a registered nurse seeking purpose-driven work,professional growth, and the flexibility to balance your life andcareer-this is your opportunity. Apply today and help shape the future of healthcare quality in Pennsylvania.
Requirements
Be available as a full-time consultant, approximately 37.5 hours per week;
• Possess a current license to practice as a Registered Nurse issued by the Pennsylvania
State Board of Nursing; or possess a non-renewable temporary practice permit issued
by the Pennsylvania State Board of Nursing. Resources possessing non-renewable
temporary practice permits must obtain licensing as a Registered Nurse within the
one-year period as defined by the Pennsylvania State Board of Nursing;
• Possess a documented work history of three (3) or more years of professional
experience with medical assistance, health care services or human services or any
equivalent combination of experience and training;
• Possess basic computer skills, including familiarity with Microsoft Office programs.
Principal Duties and Responsibilities (RN - Medical Assistance Hospice Integrity)
  • Conduct clinical utilization reviews for hospice services under the Medical Assistance (MA) Program by evaluating medical records, terminal diagnoses, prognostic indicators, and plans of care to determine eligibility, medical necessity, appropriateness, and level of care.
  • Apply registered nursing clinical judgment and evidence-based hospice and palliative care standards to ensure MA recipients receive compassionate, appropriate, and high-quality end-of-life care consistent with program requirements and patient goals.
  • Review hospice certifications and recertifications, physician narratives, interdisciplinary team documentation, and supporting clinical evidence to validate terminal prognosis and continued hospice eligibility.
  • Assess hospice provider billing, claims, and documentation to ensure compliance with MA hospice regulations and identify potential fraud, waste, or abuse related to levels of care, service intensity, or length of stay.
  • Review documentation submitted through electronic provider portals, fax, telephone communications, and U.S. mail to support timely and accurate hospice utilization determinations.
  • Make authorization determinations within RN scope of practice by approving, modifying, or denying hospice service requests, or referring cases to physician advisors when prognosis, level of care (routine home care, continuous care, inpatient respite, or general inpatient), or medical necessity is unclear.
  • Collaborate with physician/medical consultants to support peer-to-peer discussions with hospice medical directors and certifying physicians regarding prognosis, symptom management, and appropriate hospice level of care.
  • Accurately document clinical findings, utilization review decisions, and rationale in electronic systems, generating authorization notifications, denial letters, reason codes, and appeal rights in accordance with MA regulations.
  • Conduct re-evaluations of previously denied or modified hospice services upon request by hospice providers or facilities, in collaboration with physician/medical consultants as appropriate.
  • Review hospice-related appeals by analyzing medical records, preparing case summaries and exhibits, and providing testimony at administrative hearings using knowledge of MA hospice regulations, utilization review principles, and appeal procedures.
  • Interpret MA hospice policies, regulations, and utilization management guidelines for internal staff, hospice providers, and stakeholders through consultation, meetings, and educational outreach.
  • Participate in interdisciplinary collaboration with hospice providers, medical consultants, legal staff, and program leadership to support consistent, defensible, and patient-centered utilization determinations.
  • Maintain professional competence through continuing education, hospice-specific training, and review of current palliative care literature to remain current with evolving standards of end-of-life care and regulatory requirements.
  • Provide cross-coverage in other MA program areas as needed, maintaining working knowledge through training and updates to support continuity of operations.
  • Respond to inquiries and correspondence from recipients, hospice providers, legislators, legal offices, and external agencies to explain hospice coverage criteria, utilization decisions, and administrative processes.
  • Maintain complete and accurate records in compliance with MA hospice regulations, accreditation standards, and organizational policies.
  • Perform related duties and special projects as assigned, with expectations and performance standards communicated at the time of assignment.
  • When required, work at Department-designated locations. The primary work location is Harrisburg, PA, where appropriate workspace, technology, and resources will be provided to support assigned duties.

Benefits
Attractive Compensation plan.Holiday and Vacation program.

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