Build and present performance reviews and executive-ready reporting; drive corrective action plans ... Recommend technology improvements (automation, templates, dashboards, portal utilization) to ...
Build and present performance reviews and executive-ready reporting; drive corrective action plans ... Recommend technology improvements (automation, templates, dashboards, portal utilization) to ...
... utilization, backlog, revenue forecasting, margin, and active project health (delivery status ... PS Team quarterly reviews, capacity planning cycles, resource allocation/project assignments, and ...
... utilization, backlog, revenue forecasting, margin, and active project health (delivery status ... PS Team quarterly reviews, capacity planning cycles, resource allocation/project assignments, and ...
... utilization management, or a related clinical specialty * Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows * Solid understanding of clinical ...
... utilization management, or a related clinical specialty * Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows * Solid understanding of clinical ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Quick apply
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · On-site +1
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · On-site +1
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Ensure operational audits, quality reviews, and corrective actions are completed consistently and ...
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Ensure operational audits, quality reviews, and corrective actions are completed consistently and ...
Electrical Engineering Department Head
Conyers, GA · On-site +1
$97K - $125K/yr
... Remote (Hybrid options available) About Raymond: We are a progressive, forward-thinking ... Monitor and manage departmental workload, utilization, staffing assignments, and resource planning.
Electrical Engineering Department Head
Conyers, GA · On-site +1
$97K - $125K/yr
... Remote (Hybrid options available) About Raymond: We are a progressive, forward-thinking ... Monitor and manage departmental workload, utilization, staffing assignments, and resource planning.
Clinical Account Executive Hereditary Cancer - Atlanta, GA
Atlanta, GA · On-site +1
$105K - $130K/yr
Expand menu utilization in existing accounts * Sell genetic diagnostic testing services to new ... Experience with customer base within territory #LI-JP1 #LI-REMOTE PRIVACY NOTICES To review Ambry ...
Clinical Account Executive Hereditary Cancer - Atlanta, GA
Atlanta, GA · On-site +1
$105K - $130K/yr
Expand menu utilization in existing accounts * Sell genetic diagnostic testing services to new ... Experience with customer base within territory #LI-JP1 #LI-REMOTE PRIVACY NOTICES To review Ambry ...
Clinical Account Executive Hereditary Cancer - Atlanta, GA
Atlanta, GA · On-site +1
$105K - $130K/yr
Expand menu utilization in existing accounts * Sell genetic diagnostic testing services to new ... Experience with customer base within territory #LI-JP1 #LI-REMOTE PRIVACY NOTICES To review Ambry ...
Clinical Account Executive Hereditary Cancer - Atlanta, GA
Atlanta, GA · On-site +1
$105K - $130K/yr
Expand menu utilization in existing accounts * Sell genetic diagnostic testing services to new ... Experience with customer base within territory #LI-JP1 #LI-REMOTE PRIVACY NOTICES To review Ambry ...
Preparing and presenting regular client performance reviews, including identification of cost drivers, recommendations for cost savings opportunities, utilization and cost reports * Prioritizes and ...
Preparing and presenting regular client performance reviews, including identification of cost drivers, recommendations for cost savings opportunities, utilization and cost reports * Prioritizes and ...
Cloud Solution Architect
Atlanta, GA · Remote
$61 - $83.75/hr
Support hands-on delivery as needed, including Salesforce configuration, data loads, and review of ... Proven leadership of Salesforce delivery teams, including onshore/offshore models, remote teams ...
Quick apply
Cloud Solution Architect
Atlanta, GA · Remote
$61 - $83.75/hr
Support hands-on delivery as needed, including Salesforce configuration, data loads, and review of ... Proven leadership of Salesforce delivery teams, including onshore/offshore models, remote teams ...
Service Delivery Manager - Remote - USA
Atlanta, GA · On-site +1
Comfortable owning engagement financials under a fixed-fee structure: capacity and utilization ... Able to run a budget and progress review with a client sponsor and de-escalate a difficult ...
Service Delivery Manager - Remote - USA
Atlanta, GA · On-site +1
Comfortable owning engagement financials under a fixed-fee structure: capacity and utilization ... Able to run a budget and progress review with a client sponsor and de-escalate a difficult ...
Senior Director, Professional Services
Atlanta, GA · Remote
$10K/mo
This is a full-time exempt and remote position. Candidates must be located in the United States ... Drive improvements in throughput, resource utilization, and burn rate while maintaining high ...
Quick apply
Senior Director, Professional Services
Atlanta, GA · Remote
$10K/mo
This is a full-time exempt and remote position. Candidates must be located in the United States ... Drive improvements in throughput, resource utilization, and burn rate while maintaining high ...
This position will be remote within the designated market with occasional in-home patient treatment ... Review and approve APP, RN, SW and Pharmacy plans of care. * Review, approve and co-sign APP ...
This position will be remote within the designated market with occasional in-home patient treatment ... Review and approve APP, RN, SW and Pharmacy plans of care. * Review, approve and co-sign APP ...
Director of Digital Solutions
Lawrenceville, GA · On-site +1
Remote or any Colony Bank location with available space Position Overview: The Director of Digital ... Negotiate contracts, manage Service Level Agreements (SLAs), and conduct quarterly business reviews.
Director of Digital Solutions
Lawrenceville, GA · On-site +1
Remote or any Colony Bank location with available space Position Overview: The Director of Digital ... Negotiate contracts, manage Service Level Agreements (SLAs), and conduct quarterly business reviews.
This position will be remote within the designated market with occasional in-home patient treatment ... Review and approve APP, RN, SW, and Pharmacy plans of care, and co-sign APP encounters. * Provide ...
This position will be remote within the designated market with occasional in-home patient treatment ... Review and approve APP, RN, SW, and Pharmacy plans of care, and co-sign APP encounters. * Provide ...
$27 - $29/hr
In this role, you'll ensure our Peer Review case reports are nothing short of exceptional ... The position is 100% remote with a schedule of Monday through Friday: * 12:00pm - 8:30pm EST ...
$27 - $29/hr
In this role, you'll ensure our Peer Review case reports are nothing short of exceptional ... The position is 100% remote with a schedule of Monday through Friday: * 12:00pm - 8:30pm EST ...
This role is Monday - Friday 100% remote aside from travel to tradeshows and exhibitions on average ... Claims , workers compensation , bill review , or similar experience required * Ability to assist ...
This role is Monday - Friday 100% remote aside from travel to tradeshows and exhibitions on average ... Claims , workers compensation , bill review , or similar experience required * Ability to assist ...
This role is Monday - Friday 100% remote aside from travel to tradeshows and exhibitions on average ... Claims , workers compensation , bill review , or similar experience required * Ability to assist ...
This role is Monday - Friday 100% remote aside from travel to tradeshows and exhibitions on average ... Claims , workers compensation , bill review , or similar experience required * Ability to assist ...
Cigna Utilization Review Remote information
What is a Cigna Utilization Review Remote?
What are the key skills and qualifications needed to thrive as a Cigna Utilization Review Remote nurse?
What are some common challenges faced by Cigna Utilization Review professionals working remotely, and how can these be effectively managed?
What is the difference between Cigna Utilization Review Remote vs Cigna Medical Reviewer?
| Aspect | Cigna Utilization Review Remote | Cigna Medical Reviewer |
|---|---|---|
| Credentials | RN or licensed healthcare professional | RN or licensed physician |
| Work Environment | Remote, telehealth setting | Remote or onsite, clinical setting |
| Employer & Industry | Cigna, health insurance industry | Cigna, healthcare and insurance industry |
| Primary Focus | Review of insurance utilization for appropriateness | Clinical 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 popular job titles related to Cigna Utilization Review Remote jobs in Georgia?
For Cigna Utilization Review Remote jobs in Georgia, the most frequently searched job titles are:
- Insurance Review Nurse
- Remote Concurrent Review Nurse
- Medical Claim Review Nurse
- Evening Utilization Review Nurse
- Part Time Utilization Review Nurse
- Remote Behavioral Health Utilization Review
- No Experience Utilization Review Nurse
- Remote Utilization Review Social Worker
- Contract Utilization Review Nurse
- Medicare Review Nurse
What job categories do people searching Cigna Utilization Review Remote jobs in Georgia look for?
The top searched job categories for Cigna Utilization Review Remote jobs in Georgia are:
- Aetna Utilization Review Nurse
- Remote Dental Utilization Review
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- Utilization Review Manager
- Optum Utilization Review Nurse
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- Remote Optum Utilization Review
What cities in Georgia are hiring for Cigna Utilization Review Remote jobs?
Cities in Georgia with the most Cigna Utilization Review Remote job openings:

Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 15 days ago
Harris Computer rating
8.5
Based on 10 frontline employees who took The Breakroom Quiz
81st of 247 rated software companies
Job description
MEDHOST, a division of Harris; is seeking an Account Follow-Up Services Team Leader who will provide strategic oversight of Hospital Insurance Follow-Up Services, including multi-team performance, payer strategy, denial prevention initiatives, workforce planning, and operational scaling.
This role drives measurable improvement in A/R aging, collections performance, and denial overturn rates through KPI leadership, cross-functional collaboration, training programs, continuous process innovation and adjust priorities on the fly.
This remote role welcomes candidates anywhere in the US. Preference will be given to candidates who can work in CST timezone.
Salary:
60K - 70K
AI & Innovation Mindset
We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency. Candidates should be comfortable using AI enabled technologies, including copilots, chat based AI assistants, and automation tools, as part of their everyday work while maintaining appropriate judgment, security, and compliance standards.
What your impact will be:
Operational & Performance Leadership
- Own performance across one or more Insurance Follow-Up teams (or multiple clients).
- Set daily/weekly/monthly targets for productivity, quality, and collections, ensuring adherence to service-level expectations.
- Lead KPI governance (Days in A/R, A/R > 90, denial rate, overturn rate, net collection rate, first-pass resolution, productivity per FTE, quality).
- Build and present performance reviews and executive-ready reporting; drive corrective action plans.
Denials Strategy & Payer Optimization
- Lead payer trend analysis and root-cause programs to reduce preventable denials (eligibility, auth, coding/modifiers, timely filing, medical necessity, COB).
- Standardize best practices for appeals, reconsiderations, and payer escalations.
- Partner with leadership on payer playbooks and escalation pathways; ensure consistent documentation standards.
Training, Enablement & Quality Control
- Design and maintain scalable training programs, SOPs, and payer-specific job aids.
- Establish QA frameworks and audit cadence; monitor error trends and implement remediation plans.
- Develop team leads and high-potential staff through structured coaching and succession planning.
Innovation & Process Improvement
- Drive workflow optimization through queue design, inventory management, and prioritization strategies.
- Recommend technology improvements (automation, templates, dashboards, portal utilization) to increase output and reduce rework.
- Lead change management and adoption for new tools, payer policy updates, and client requirements.
Cross-Functional & Client Partnership
- Collaborate with coding, payment posting, charge entry, eligibility, and client stakeholders to resolve systemic issues impacting AR.
- Participate in client performance calls and support recovery plans for at-risk KPIs.
What we are looking for:
- 3-5+ years of RCM experience with deep Insurance Follow-Up/Denials expertise.
- 2-4+ years leading teams (supervisor/team lead/manager level).
- Demonstrated success improving KPI outcomes (A/R aging reduction, denial reductions, increased overturn rate, improved collections).
- Strong analytics/reporting capability (Excel required; dashboard/reporting tools preferred).
- Advanced knowledge of payer behavior, denial categories, escalation processes, and appeals best practices.
- Ability to travel when required to client site.
- High Speed Internet access (minimum 300 Mbps download speed) and unlimited data.
- Smart phone for Multi Factor Authentication (MFA) application.
- Excellent communication skills (verbal & written), good judgement, tact, initiative, and resourcefulness.
- Must be detail oriented, organized, and ability to multi-task.
- Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
- Must be flexible with a "can do" attitude and have the ability to remain professional under high pressure situations.
What we can offer:
- 3 weeks' vacation and 5 personal days
- Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
- Employee stock ownership and RRSP/401k matching programs
- Lifestyle rewards
- Remote work and more!
About MEDHOST:
MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms. Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.
About Harris:
Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses.
#LI-remote
What Harris Computer employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Harris Computer Systems
Sourced by ZipRecruiter
Harris Computer Systems, based in Ottawa, ON, CA, is an established player in the field of public sector software technology. Since its inception in 1976, the company has been striving to make clients' operations more efficient through reliable, practical, and flexible software solutions. Its extensive portfolio primarily serves utility, healthcare, public sector, and educational institutions, contributing to the betterment of public services through technology. Harris strongly believes in the value of forward-thinking technology and the power it has to drive progress for the public sector. This methodology is entirely in line with their mission to ensure customer success by providing reliable, practical, and robust software solutions.
Industry
Accounting services
Company size
1,001 - 5,000 Employees
Headquarters location
Ottawa, ON, CA