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Cigna Utilization Review Remote Jobs in Colorado

This position is 100% Remote Key Responsibilities * Develop and implement innovative sourcing ... care and utilization management review needs. * Conduct warm and cold outreach to clinicians ...

Data Engineer, Senior

Denver, CO · On-site +1

$140K - $170K/yr

Hybrid or Remote, however must reside in the following states: WA, OH, CA, AZ, CO, CT, FL, GA, MD ... Mentor and support Data Engineers through code reviews, knowledge sharing, and engineering guidance.

Showing results 41-48

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 cities in Colorado are hiring for Cigna Utilization Review Remote jobs? Cities in Colorado with the most Cigna Utilization Review Remote job openings:
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.

Provider Network Recruiter

LifeHealth

Littleton, CO • Remote

Full-time

Posted 7 days ago


Job description

Job Title:Network Recruiter - EAP

Position Overview

The Network Recruiter will strategically source, engage, and onboard EAP Providers across a broad range of specialties-spanning counseling services to critical incident response providers.

Unlike traditional hospital recruiting, this role focuses on attracting mental health clinicians for flexible, as-needed EAP work. Responsibilities include both warm and cold outreach, guiding prospective clinicians through efficient and supportive onboarding experience, and helping to build the foundation for strong clinician engagement and long-term retention. This role is ideal for a recruiter who enjoys solving complex talent challenges and contributing to behavioral healthcare quality at a national level.

Position is Exempt

Hours: Monday - Friday - start/end hours may depend on geographic location

Location: This position is 100% Remote

Key Responsibilities

  • Develop and implement innovative sourcing strategies to attract mental health EAP clinicians, including digital outreach, specialty-focused campaigns, and direct engagement.
  • Recruit licensed mental health professionals across diverse specialties (e.g., counseling, psychology, social work) to support quality of care and utilization management review needs.
  • Conduct warm and cold outreach to clinicians through phone, email, networking, referrals, and digital recruitment strategies.
  • Maintain an active pipeline to ensure a scalable, ready to deploy EAP network.
  • Serve as a primary point of contact for prospective and current providers through phone and email communication channels.
  • Communicate professionally as a representative of LifeHealth, LLC to ensure an exceptional provider experience.
  • Respond promptly to provider with inquiries and communicate key information to internal teams.
  • Negotiates market-specific rates with providers to ensure quality and cost-effectiveness, while delivering compelling value propositions that align provider's capabilities with organizational needs.
  • Manage the provider onboarding process, ensuring timely and accurate completion of all applications and documentation.
  • Monitor credentialing milestones and compliance requirements with high attention to detail.
  • Ensure adherence to corporate policies, including HIPAA Privacy and Security rules.
  • Monitor network capacity to ensure adequate clinical coverage across behavioral health specialties.
  • Apply target recruitment strategies to address coverage gaps and evolving specialty needs.
  • Track operational metrics and provide regular updates to leadership.
  • Support departmental tasks, initiatives, and projects assigned.
  • Contribute to continuous improvement of recruitment, onboarding, and provider engagement processes.
  • Experience with facilitating and assisting provider inquiries about credentialing and contracts.
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Required Qualifications

  • 2+ years of provider-facing experience in healthcare, provider relations, network recruitment, healthcare staffing, EAP operations, behavioral health recruitment, or related healthcare environments.
  • Experience engaging healthcare providers through phone, email, or direct outreach.
  • Comfortable learning and utilizing recruitment systems, databases, and technology platforms.
  • Strong organizational, communication, and relationship-building skills.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Includes fingerprinting and a background investigation that covers a seven-year investigative scope and drug screen.

Preferred Qualifications/Experience:

  • High integrity, detail-oriented, and strong work ethic.
  • Excellent verbal and written communication skills.
  • Excellent organizational skills and ability to work independently.
  • Strong teamwork and customer service skills
  • Proven ability to recruit across multiple specialties.
  • Strong written communication and outreach skills
  • Highly organized, deadline-driven, and self-directed
  • Creative thinker who can engage physicians beyond traditional sourcing methods

LifeHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status sexual orientation or gender identity.