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Cigna Utilization Review Nurse Jobs (NOW HIRING)

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Do you have experience with Utilization Review? * Do you have an Active Registered Nurse License? About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range ...

Miami Jewish Health

Utilization Review Nurse

Miami, FL · On-site

Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting prospective, concurrent, and retrospective clinical reviews to determine medical necessity, level of care, and ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

University of Utah

Utilization Review Nurse

Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...

silvercross

Utilization Review Nurse

New Lenox, IL

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...

Medix

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

Job Summary Our client is seeking a Utilization Review Nurse responsible for managing the complete Utilization Management (UM) process, from admission through discharge planning. The primary goal is ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... This position is responsible for performing initial, concurrent review activities; discharge care ...

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How much do cigna utilization review nurse jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for cigna utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are the typical daily responsibilities of a Cigna Utilization Review Nurse?

As a Cigna Utilization Review Nurse, you will review patient medical records to determine the necessity and appropriateness of hospital admissions, treatments, and services based on clinical guidelines. You'll interact with healthcare providers, case managers, and sometimes members to obtain additional information, clarify care plans, and ensure timely authorizations. Most of your work will involve thorough documentation, use of specialized software, and adherence to regulatory and company protocols. The role is primarily office-based or remote, offering structured hours, and you’ll be part of a collaborative team focused on ensuring high-quality, cost-effective patient care.

What are the key skills and qualifications needed to thrive as a Cigna Utilization Review Nurse?

To thrive as a Cigna Utilization Review Nurse, you need a valid RN license, strong clinical assessment skills, and experience in utilization management or case review. Familiarity with medical management software, clinical guideline databases (such as Milliman or InterQual), and health insurance regulatory standards is crucial. Excellent written and verbal communication, critical thinking, and attention to detail help you effectively evaluate care needs and coordinate with healthcare providers. These competencies ensure accurate case reviews, regulatory compliance, and positive outcomes for both patients and the organization.

What is a Cigna Utilization Review Nurse?

A Cigna Utilization Review Nurse evaluates medical services and treatments to ensure they meet established guidelines for medical necessity, cost-effectiveness, and policy compliance. They review patient records, coordinate with healthcare providers, and determine if requested procedures align with Cigna’s coverage criteria. This role helps manage healthcare costs while ensuring patients receive appropriate care. It typically involves collaboration with physicians, case managers, and claims specialists. Nurses in this role must have clinical experience, strong analytical skills, and knowledge of insurance policies.

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Cigna Utilization Review Nurse jobs near you
Infographic showing various Cigna Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Granville Health System

Oxford, NC • On-site

Other

Re-posted 19 days ago

Granville Health System rating

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Position Summary:

Conducts patient reviews as specified in review plan using screening criteria; identifies and documents actual and potential delays in services or treatment and works with departments and other providers to resolve problems; communicates to attending physician need for documentation for admission or continuation of hospitalization; refers cases that do not meet criteria to Director when needed. Screens all cases against high risk screens for discharge planning; conduct concurrent and retrospective reviews.

Qualifications:

North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization management criteria and standards. Excellent communication skills. Ability to work with physicians and hospital staff. Maintains professional knowledge and skills related to areas of responsibility. Self direction with the ability to work with minimal supervision and manage multiple tasks. Demonstrates understanding of variations in care of the following age groups - newborn, infant, child, adolescent, adult and geriatric.

What Granville Health System employees say

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Hours and flexibility

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