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Actalent

Clinical Review Nurse - Remote

$34 - $40/hr

We are seeking an experienced Clinical Review Nurse (RN) to join our growing healthcare team. In this fully remote role, you will evaluate medical records, determine medical necessity, and ensure ...

National Nurse Triage Inc

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over ... Registered Nurse; preferably in the ICU, ED, Mother/Baby unit, Peds, Home Health & Hospice ...

Cigna

RN Health Coach - Evernorth - Remote

Refer customer to other Cigna Evernorth clinical programs or client specific programs as clinically ... * RN required with active, unrestricted license in respective state, and ability to maintain

Cigna

RN Health Coach - Evernorth - Remote

Refer customer to other Cigna Evernorth clinical programs or client specific programs as clinically ... * RN required with active, unrestricted license in respective state, and ability to maintain

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How much do cigna rn remote jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for cigna rn remote in the United States is $44.91, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $53.37 per hour, depending on experience, location, and employer.

What is a Cigna RN Remote?

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 skills and qualifications are needed for a Cigna RN Remote?

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 challenges do Cigna RN Remote professionals face, 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.

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Cigna Rn Remote jobs near you
Infographic showing various Cigna Rn Remote job openings in the United States as of September 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% Remote job distribution, with an average salary of $93,419 per year, or $44.9 per hour.

Physical Health Registered Nurse (Remote)

Remote

Vaya Health
Health Care and Social Assistance • 201 - 500 employees
Learn more about Vaya Healthexternal

Other

Re-posted 9 days ago

Vaya Health rating

7.9

Company rating: 7.9 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

LOCATION: Remote - this a home based, virtual position that operates Monday - Friday from 8:30am-5:00pm EST. Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.
GENERAL STATEMENT OF JOB
The Physical Health Registered Nurse is responsible for completing clinical reviews for appropriateness, medical necessity, and quality. The Physical Health Registered Nurse applies standardized clinical review criteria to determine medical necessity for service authorization requests. The Physical Health Registered Nurse refers service authorization requests to an appropriate physician peer reviewer when medical necessity criteria are not clearly met. Reviews performed by the individual in this position may be pre-service, concurrent, or retrospective in nature. This position is part of a team of nurses, physicians, psychologists, pharmacists and non-clinical associates who work closely to care for our members.
The day-to-day operations of the Physical Health Utilization Management Department require coverage on weekends and holidays. The incumbent in this position will be required to participate in a rotation to ensure coverage every day including weekends and holidays. The amount of work on scheduled weekends and holidays will be subject to change.
ESSENTIAL JOB FUNCTIONS
Process requests for authorization of services:
  • Responsible for reviewing requests for authorization of services including inpatient hospital admissions, re-admissions, inpatient rehabilitation services, skilled nursing admissions, home care /home infusion services, outpatient and/or inpatient services as designated.
  • Documents timely decisions and actions taken within the managed care information system (MCIS).
  • Meets contractual timelines for completion of review activities
  • Communicates and interacts with providers as well as internal and external partners to facilitate and coordinate the activities of the UM process.
  • Utilizes technology (computer-based systems) and resources to support work activities appropriately.
  • Communicates determinations to providers per established business process
Supporting UM Functions:
  • Actively participates in all required staff meetings and complex case rounds
  • Perform discharge planning to achieve safe and timely enrollee discharges from hospitals and facilities
  • Successfully completes Inter-rater Reliability (IRR) training, exams, and testing with at least an 80% passing rate or above thresholds established by management
  • Follows all UM workflow processes
All other duties as assigned in support of UM functions.
KNOWLEDGE, SKILLS, & ABILITIES
This position requires a high degree of autonomy, professional relationships and organizational skills. Applicants with thorough knowledge of the following are prioritized:
  • Primary care, behavioral health and healthcare system in NC;
  • Vaya Health Provider Network;
  • Medical practice workflows;
  • Vaya contracts with the NC Department of Heath and Human Services (NCDHHS) and other contracts for which Vaya is responsible;
  • Vaya organizational purpose/role per federal and state statute, strategic plan, leadership and departmental roles, relationships and scope;
  • Federal and state confidentiality requirements;
  • Member and staff health & safety requirements;
  • Corporate compliance requirements;
  • Vaya Policies and Procedures;
  • Project management principles.
Additional required skills and abilities include but are not limited to the following:
  • Clear, concise and appropriate verbal, written and electronic communication;
  • Ability to present in large group settings;
  • Ability to adapt to rapid changes;
  • Effectively implement new initiatives;
  • Computer literacy and familiarity with Microsoft Office software as well as Vaya's Administrative Health Record and/or Care Management Platform, Vaya's Member Services and UM Platform.
  • Strong conceptual skills, with knowledge and skill in problem-solving, decision-making, conflict resolutions, and critical thinking.
  • Ability to mentor, coach and facilitate change and innovation.
  • Ability to develop reporting mechanisms that will produce data needed to support and benchmark quality initiatives.
EDUCATION & EXPERIENCE REQUIREMENTS
Associate Degree in Nursing required. Bachelor's Degree in Nursing preferred.
  • Five (5) years of clinical experience preferably across the continuum of care with at least two years of acute care experience.
  • Experience performing utilization management or care management functions.
  • Proficient at using software programs such as Microsoft Office tools.
Preferred Work Experience:
  • Two years of experience performing UM functions in a managed care setting
  • Experience with Milliman Care Guidelines (MCG)
  • Experience with Guiding Care software platform
PHYSICAL REQUIREMENTS
  • Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
  • Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
  • Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
  • Mental concentration is required in all aspects of work.

Licensure/Certification Required:
Active and unrestricted RN License in the State of North Carolina or Nurse Licensure Compact (NLC) license.
RESIDENCY REQUIREMENTS: The person in this position must live in NC, SC, GA, TN, VA, MD, or FL.
SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open Until Filled
APPLY: Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/.
Vaya Health is an equal opportunity employer.

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