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Cigna Utilization Review Remote Jobs in Washington

Walkerdunlop

Senior Accountant, Tax

Bethesda, MD · On-site +1

$80K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Primary Responsibilities * Assist in the preparation and review of corporate tax returns, including ... Comprehensive benefit options* that have earned Walker & Dunlop the gold level of the 2025 Cigna ...

Persado

Senior Account Manager

Washington, DC · On-site +1

$105K - $125K/yr

  • Retirement

... review of compliance risks. Used by 8 out of the top 10 US banks today, the Persado platform ... This is a remote role, but candidates should be located on the East Coast, preferably within the ...

Emmes

Safety Manager - Cell and Gene

Rockville, MD · On-site +1

  • Medical

  • Retirement

Overview Safety Manager US Remote Emmes Group: Building a better future for us all. Emmes Group is ... Reviews safety events. * Oversees the collection, assessment, monitoring, review and reporting of ...

SOSi

DoD SkillBridge Logistics Manager

Reston, VA · On-site +1

... utilization of logistics support services. Responsibilities: * Foster a team-oriented work ... Reviews and analyzes reports, such as revenue and performance records to recommended process ...

Iridium Satellite, LLC

Senior Program Finance Analyst

Mclean, VA · Remote

$86K - $107K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... and remote operations all rely on Iridium to stay connected. We take our responsibility for ... program reviews that highlight funding status, unbilled analysis, aged receivables, utilization ...

Iridium Satellite, LLC

Senior Program Finance Analyst

Mclean, VA · Remote

$86K - $107K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... and remote operations all rely on Iridium to stay connected. We take our responsibility for ... program reviews that highlight funding status, unbilled analysis, aged receivables, utilization ...

Shield Consulting Solutions

Senior Network Engineer

Laurel, MD · On-site +1

$190K - $200K/yr

  • Medical

  • Retirement

  • PTO

... remote locations, and including operational international links. * Works with senior IT peers or ... Familiar with STE/STN requirements to meet STIG/Security mandates and the utilization of Nessus ...

Shield Consulting Solutions

Senior Network Engineer

Laurel, MD · On-site +1

$190K - $200K/yr

  • Medical

  • Retirement

  • PTO

... remote locations, and including operational international links. Works with senior IT peers or ... Familiar with STE/STN requirements to meet STIG/Security mandates and the utilization of Nessus ...

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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:

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

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

Cigna Utilization Review Remote jobs near you

Task Order Project Manager

VivSoft Technologies LLC

Herndon, VA • On-site, Remote

$120K - $136K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

Job description

About VivSoft:
VivSoft is a mission-driven technology company specializing in Cloud, DevSecOps, Artificial Intelligence, and Digital Experience. We are a diverse team of innovators dedicated to creating open, scalable, and automated solutions that drive digital transformation in the federal sector. Our work culture fosters collaboration, creativity, and continuous learning.
Job Summary:
The Task Order Project Manager is responsible for overseeing all aspects of the OneStream Functional Integrator support contract. This role manages scope, schedule, resources, and communications across stakeholders and ensures that all task order requirements are met through effective planning, execution, and monitoring.
Key Responsibilities:
  • Provide programmatic support to stakeholders and project teams for execution of assigned project schedules and deliverables.
  • Develop, update, and maintain project plans, schedules, and resource assignments aligned with performance work statement (PWS) requirements.
  • Facilitate contract kick-off and transition-in activities; lead regular In-Process Reviews (IPRs) and executive briefings.
  • Manage project documentation, meeting minutes, reports, and communication materials for internal and external stakeholders.
  • Coordinate non-disclosure agreements, monthly status reports, CAC accountability reports, and compliance with DoD 8570/8140 certification tracking.
  • Lead preparation and submission of transition plans in the event of follow-on contract transitions.
  • Ensure accurate and timely reporting on task progress, risks, and resource utilization to the Contracting Officer's Representative (COR) and PMO.

Qualifications:
  • Bachelor's degree in Project Management, Business Administration, Information Technology, or related field.
  • Must possess an active Secret security clearance.
  • Minimum of 7 years of experience managing large-scale federal IT programs or task orders, preferably in the DoD environment.
  • Proven track record managing Agile-based and multi-task project environments involving ERP or financial system implementations.
  • Proficient in project management tools and methodologies (e.g., Microsoft Project, Jira, Agile)
  • Strong understanding of federal contract and task order management processes
  • Familiarity with DOD 8570/8140 certification tracking and reporting
  • Experience in preparing transition plans and executing contract onboarding/offboarding
  • Excellent communication, reporting, and stakeholder engagement skills

Benefits:
  • Comprehensive Medical, Dental, and Vision Plans (Healthcare benefits are 100% employer-paid for employees only)
  • Life Insurance
  • Paid Time Off (Flexible/Combined PTO, Bereavement Leave, 11 Company Paid Holidays)
  • 401K Retirement Plan with employer match
  • Professional Development Training Reimbursement
  • Flexible/remote work schedules

Apply