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Cigna Utilization Review Remote Jobs in Washington

Centerbrite Health

BCBA

Fairfax, VA · On-site +1

$90K - $110K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ... Remote and in-clinic Job Types: Full-time

Sasaki Evolutionary Integration Services (SEIS), LLC

Be Seen First

Software Development Engineer III - Remote

Chantilly, VA · Remote

$130K - $157K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Review and approve technical designs and code produced by other engineers. Advanced Development ... utilization. · Collaborate with software developers, business analysts, project managers, and ...

Koniag, Inc.

FinOps Specialist (REMOTE)

Washington, DC · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

kgs

FinOps Specialist (REMOTE)

Washington, DC · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

kgs

FinOps Specialist (REMOTE)

Washington, DC · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

Ignite IT

Senior Network Security Engineer

Suitland, MD · Remote

$63 - $82.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... reviews, recertification, cleanup, and decommissioning. * Install, configure, maintain, patch ... remote users, certificates, authentication policies, availability, utilization, and user access ...

Bcbsa

Director, Trade Client Relations

Gaithersburg, MD · Remote

$155K - $175K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

AvantGarde, LLC

Program Manager

Washington, DC · On-site +1

Remote work options are available after a brief acclimation period. Essential Duties and ... reviews, and governance audits to identify risks, trends, and opportunities for improvement. · ...

VivSoft Technologies

Task Order Project Manager

Herndon, VA · Remote

$120K - $136K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Facilitate contract kick-off and transition-in activities; lead regular In-Process Reviews (IPRs ... Ensure accurate and timely reporting on task progress, risks, and resource utilization to the ...

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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 popular job titles related to Cigna Utilization Review Remote jobs in Washington?

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

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

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

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Cities in Washington with the most Cigna Utilization Review Remote job openings:

Cigna Utilization Review Remote jobs near you

BCBA

Centerbrite Health

Fairfax, VA • On-site, Remote

$90K - $110K/yr

Full-time, Part-time

Medical, Dental, Vision, Retirement, PTO

Posted 27 days ago

Job description

BCBA (Board Certified Behavior Analyst)
We're building a care delivery model that replaces fragmented services, inconsistent quality, and constant churn with clear clinical standards, measured outcomes, and sustainable staffing.
As our BCBA, you won't inherit someone else's broken playbook - you'll help write the first one. This role is designed to be flexible from the start: come in part-time and grow into full-time as the caseload builds, on your timeline. You'll work closely with our Clinical Advisors, so you'll have real mentorship and support - not just autonomy without a net.
What you'll do:
  • Contribute to clinical program design as we build out our service model from the ground up
  • Carry and manage a client caseload, serving as the clinical standard-bearer for the organization
  • Own documentation quality, utilization reviews, and oversight of treatment plans
  • Supervise RBTs across active cases, ensuring treatment fidelity and consistent skill-building
  • Partner directly with the founding team on clinical hiring decisions and onboarding as we grow

What's different here:
  • Clinical Director track: this role is built to grow into clinical leadership as the organization scales
  • Mentorship: work directly alongside our Clinical Advisors - you'll be supported, not thrown in the deep end
  • Reasonable workload: proper caseload sizing and RBT ratios from day one - no heroics required
  • Mission: serve families who've been let down by fragmented, impersonal care

Compensation & Growth:
  • Compensation ranges from $90,000-$110,000 annually
  • Quarterly performance bonuses

What you bring:
  • Active BCBA certification in good standing (Required)
  • NJ BCBA licensure (Required)
  • Experience in a clinic setting (a plus)

Benefits:
  • Health, dental, and vision from day one
  • 401(k) with matching
  • PTO that you'll actually use
  • Referral bonuses when you bring great people in
  • CEU support - staying current matters here
  • Relocation Assistance
  • Parental leave
  • Monday-Friday daytime hours, no weekends

Work Location (Hybrid): Remote and in-clinic
Job Types: Full-time

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