ZipRecruiter

Log In

2

Cigna Utilization Review Remote Jobs in Florida (NOW HIRING)

MRIoA

Child & Adolescent Psychiatrist

Orlando, FL · On-site +1

We are currently seeking Board-Certified physicians in Child & Adolescent Psychiatry to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours ...

NRG MGMT LLC

Collections Specialist

Lake Worth, FL · On-site +1

$16.50 - $22.25/hr

... utilization review, and insurance verification for substance abuse and mental health treatment ... Work Environment Office or remote work environment, depending on company policy. Fast-paced ...

New

Oscar Health

Sr. Quality of Care Review Nurse

Miami, FL · Remote

$83K - $109K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Health plan utilization management experience or case management experience. * Experience in health ...

previous page

Showing results 41-60

All JobsCigna Utilization Review JobsCigna Utilization Review Remote JobsCigna Utilization Review Remote Jobs in Florida

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 the most commonly searched types of Cigna Utilization Review jobs in Florida? The most popular types of Cigna Utilization Review jobs in Florida are:
What are popular job titles related to Cigna Utilization Review Remote jobs in Florida? For Cigna Utilization Review Remote jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Cigna Utilization Review Remote jobs in Florida look for? The top searched job categories for Cigna Utilization Review Remote jobs in Florida are:
What cities in Florida are hiring for Cigna Utilization Review Remote jobs? Cities in Florida 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 Florida as of August 2026, with employment types broken down into 85% Full Time, 9% Part Time, and 6% Contract. Highlights an 100% Remote job distribution.

Physician / Neurology / Florida / Permanent / Associate Medical Director - Neurology - 100% Remote

eviCore healthcare

Jacksonville, FL • Remote

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Neurology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must have a minimum of 5 years clinical experience, beyond residency/fellowship Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is requiredNo nights, no weekends, not call.Predictable work scheduleFull and part time opportunitiesSalaried position with benefitsSupportive organization with collaborative cultureeviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:Flexible scheduling and work/life balance with remote and work from home opportunities4 weeks of PTO(starting) per year plus paid holidaysOne week of CMEEducation assistance, tuition reimbursement and professional certifications Health, dental, vision, and life benefits with employer funded HSAPaid Volunteer Community Service Days Ample opportunities for growth, advancement, and promotion 401k retirement plan with company match of 50% employee contributions up to 6% eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation

Apply