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Cigna Utilization Review Remote Jobs in Illinois

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

AltaStaff, LLC

UM RN Care Review Clinician

Chicago, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

AltaStaff, LLC

Care Review Clinician

Cherry Valley, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

AltaStaff, LLC

Care Review Clinician

Springfield, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

YO AI Labs

Hospitalist Physician - Remote

Chicago, IL · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

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Cigna Utilization Review Remote information

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 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 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 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 the most commonly searched types of Cigna Utilization Review jobs in Illinois?

The most popular types of Cigna Utilization Review jobs in Illinois are:

What are popular job titles related to Cigna Utilization Review Remote jobs in Illinois?

For Cigna Utilization Review Remote jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Cigna Utilization Review Remote jobs in Illinois look for?

The top searched job categories for Cigna Utilization Review Remote jobs in Illinois are:

What cities in Illinois are hiring for Cigna Utilization Review Remote jobs?

Cities in Illinois 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 Illinois as of August 2026, with employment types broken down into 80% Full Time, 8% Part Time, and 12% Contract. Highlights an 100% Remote job distribution.

Utilization Review Nurse

New Lenox, IL • On-site, Remote

Silver Cross Hospital
Health Care and Social Assistance • 1 - 5K employees

6.9

Company rating: 6.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

552nd of 1,064 rated hospitals

People enjoy working here

Recommended by students

Good schedule notice

Learn more about Silver Cross Hospitalexternal

$34.73 - $45.15/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 18 days ago

Job description

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated.
Position Summary: Performs medical record review for severity of illness and intensity of service; liaison function with external review agencies to ensure compliance with regulations affecting financial reimbursement; identifies variance from established pathways
Essential Duties and Responsibilities:
  • Collects information from clinical medical record for severity of illness and intensity of service and documents such in clinical database
  • Monitors all levels of care for appropriateness and communicates variance; evaluates plan of care to ensure it is based on accepted standards
  • Provides information to external review organizations, documents pertinent communications
  • Refers to designated physician advisor those patients not meeting criteria as well as quality of care concerns
  • Maintains knowledge and incorporates current standards into practice

Required Qualifications: Knowledge of clinical norms; excellent communication skills; critical thinking skills; organized and efficient time management skills
Education and Training:
  • Nurse, Registered (RN) licensure
  • BSN preferred. 2-5 years previous Utilization Review experience preferred.
  • Current CPR
  • Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred

Work Shift Details:
Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site requirement for meetings and mandatory training
Department:
CONTINUUM OF CARE
Benefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:
• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement
Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
The expected pay for this position is listed below:
$34.73 - $45.15
Silver Cross Hospital logo

About Silver Cross Hospital

Sourced by ZipRecruiter

At Silver Cross, we pride ourselves on delivering unrivaled care to every patient, every time. As a result, our focus on safety, quality and patient experience has earned us numerous national awards over the years. As the needs of our community have grown, so has Silver Cross—in both size and stature. Our many healthcare services rapidly expanded, evolved and increased in complexity. To serve you and your loved ones even better than before, we've proudly partnered with many of Chicago's leading academic medical centers, bringing extraordinarily advanced care close to home.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

New Lenox, IL, US

Year founded

1895

Social media

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Benefits

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