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Cigna Utilization Review Remote Jobs in Colorado

Standish Management

Engagement Manager

Denver, CO · On-site +1

$95K - $120K/yr

Review all communications to the client and its investors on an ongoing basis * Assist with ... Employees can choose to be classified as "flex remote" or "flex office" *Compensation range: $95 ...

Agile Space Industries, Inc.

Contracts Manager

Denver, CO · On-site +1

$99K - $150K/yr

... utilization to national defense, human exploration, and commercial space transport. We are seeking ... All stock grants are subject to executive review and approval in accordance with the Company ...

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Cigna Utilization Review Remote information

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

To thrive as a Cigna Utilization Review Remote Nurse, you need a valid RN license, clinical experience (often in case management or utilization review), and a strong understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic medical records (EMRs), and knowledge of Medicare/Medicaid policies or URAC/NCQA standards is typically required. Excellent critical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and coordinating with providers. These skills ensure accurate, compliant decisions that support patient care while managing healthcare costs efficiently in a remote environment.

What is the difference between Cigna Utilization Review Remote vs Cigna Medical Reviewer?

AspectCigna Utilization Review RemoteCigna Medical Reviewer
CredentialsRN or licensed healthcare professionalRN or licensed physician
Work EnvironmentRemote, telehealth settingRemote or onsite, clinical setting
Employer & IndustryCigna, health insurance industryCigna, healthcare and insurance industry
Primary FocusReview of insurance utilization for appropriatenessClinical assessment and direct patient care

While both roles involve healthcare review, Cigna Utilization Review Remote focuses on evaluating insurance claims remotely, whereas Cigna Medical Reviewer provides direct clinical assessments, often with more patient interaction. Both require healthcare credentials and are integral to Cigna's healthcare services, but their daily tasks and focus differ.

What are some common challenges faced by Cigna Utilization Review professionals working remotely, and how can these be effectively managed?

Cigna Utilization Review professionals working remotely often encounter challenges such as maintaining clear communication with healthcare providers and team members, managing high caseload volumes, and staying updated on evolving clinical guidelines. To address these challenges, it’s important to leverage Cigna’s robust digital collaboration tools, participate actively in virtual team meetings, and utilize ongoing training resources. Setting a structured daily routine and prioritizing tasks can also help ensure timely and accurate reviews, while maintaining work-life balance in a remote setting.

What is a Cigna Utilization Review Remote?

A Cigna Utilization Review Remote position involves evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to Cigna members—all while working from a remote location. Utilization Review professionals, often nurses or clinicians, review clinical information, make coverage determinations, and coordinate with providers to ensure members receive the right care. This role combines clinical expertise with knowledge of insurance guidelines and regulatory requirements, allowing for flexible work arrangements from home. It plays a critical role in managing healthcare costs and improving patient outcomes.
What are popular job titles related to Cigna Utilization Review Remote jobs in Colorado? For Cigna Utilization Review Remote jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Cigna Utilization Review Remote jobs in Colorado look for? The top searched job categories for Cigna Utilization Review Remote jobs in Colorado are:
What cities in Colorado are hiring for Cigna Utilization Review Remote jobs? Cities in Colorado with the most Cigna Utilization Review Remote job openings:
Cigna Utilization Review Remote jobs near you
Infographic showing various Cigna Utilization Review Remote job openings in Colorado as of August 2026, with employment types broken down into 100% Full Time. Highlights an 17% Hybrid, and 83% Remote job distribution.

Remote Utilization Manager - Inpatient

AllHealth Network

Watkins, CO • Remote

$75K - $83K/yr

Full-time

Posted yesterday

New

Job description

Join Our Team as a Utilization Review Manager (RN or Social Worker)

Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment.

Why AllHealth Network?

  • Work in a supportive, interdisciplinary environment that values your professional judgment
  • Enjoy opportunities for ongoing learning, growth, and advancement
  • Make a tangible impact on client outcomes and community well-being
  • Be part of a mission-driven organization dedicated to high-quality, client-centered care

What You'll Do:

  • Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations
  • Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units
  • Collaborate with nurses, social workers, case managers, and other healthcare professionals
  • Ensure quality care by coordinating with payers, treatment teams, and billing staff
  • Maintain accurate records and use your problem-solving skills to navigate challenging cases

What We’re Looking For:

  • Registered Nurse (BSN/RN) or Master’s in a human services field
  • Clinical license (LPC, LCSW) required 
  • Minimum 2 years’ experience in behavioral health utilization management, care coordination, or case management
  • Strong communication, organization, and advocacy skills
  • Experience with insurance processes, electronic records, and multidisciplinary teamwork

Ready to take your career to the next level with a team that cares as much as you do? Apply today and help us transform lives—one client at a time.

$75,000 - $83,000 annually 

AllHealth Network also provides a 10% compensation differential for individuals who are bilingual in English and Spanish (language proficiency testing required). 

The base salary range represents the low and high end of the AllHealth Network hiring range for this position. Actual salaries will vary and may be above or below the range based on various factors including but not limited to experience, education, training, merit, and the ability to embody the AllHealth Network mission and values.  The range listed is just one component of AllHealth Networks’ total compensation package for employees. Other rewards may include short-term and long-term incentives as well as a generous benefits package detailed below.

Apply