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Cigna Utilization Review Remote Jobs in Baltimore, MD

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

While this position is remote, the incumbent will be expected to come into a CareFirst location ... Utilization Review, Disease Management or other direct patient care experience. Preferred ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...

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Cigna Utilization Review Remote information

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$15

$31

$53

How much do cigna utilization review remote jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for cigna utilization review remote in Baltimore, MD is $31.74, according to ZipRecruiter salary data. Most workers in this role earn between $22.21 and $40.38 per hour, depending on experience, location, and employer.

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 Baltimore, MD?

The most popular types of Cigna Utilization Review jobs in Baltimore, MD are:

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

What job categories do people searching Cigna Utilization Review Remote jobs in Baltimore, MD look for?

The top searched job categories for Cigna Utilization Review Remote jobs in Baltimore, MD are:

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Cities near Baltimore, MD 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 Baltimore, MD as of June 2026, with employment types broken down into 96% Full Time, 3% Part Time, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $66,013 per year, or $31.7 per hour.

Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic

Desta Care Therapeutic

Baltimore, MD • Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Key responsibilities

  • Act as a liaison between clients, families, and healthcare providers to ensure comprehensive support.

  • Interact with insurance companies to manage pre-certifications and utilization processes.

  • Contribute to discharge planning and aftercare strategies to facilitate client transitions.

Job description

Position Overview

Desta Care Therapeutic is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our multidisciplinary team. In this full-time remote role, you will utilize your expertise in mental health to support individuals navigating complex emotional and psychological challenges. Your focus will be on delivering personalized care and making a meaningful impact in the lives of our clients, particularly within the hospice care setting.

About the Organization

Desta Care Therapeutic specializes in providing high-quality mental health services designed for a diverse population that includes individuals from various backgrounds and life experiences. We pride ourselves on creating a supportive and inclusive environment that prioritizes the well-being and personal growth of both our clients and staff. Our team comprises experienced professionals committed to promoting healing, empowerment, and resilience in our clients.

Work Environment

This remote position allows flexibility while working in a collaborative environment. You will engage with your peers either virtually or via telehealth platform, ensuring that communication remains seamless and effective. Though location-independent, our organization maintains a strong sense of community and teamwork, with regular check-ins and virtual meetings to foster collaboration and shared professional development.

Key Responsibilities
  • Act as a critical liaison between clients, families, and outpatient healthcare providers, ensuring comprehensive support for each individual’s needs.
  • Interact with insurance companies to manage pre-certifications and utilization processes necessary for effective care continuity.
  • Contribute to discharge planning and aftercare strategies that facilitate a smooth transition for clients post-treatment.
  • Provide therapeutic meal support, empowering clients to establish a healthy relationship with food while demonstrating effective coping strategies.
  • Deliver empathetic, affirming, and tailored care to clients, considering their unique circumstances and intersectional identities.
  • Document and review client interactions and care plans in accordance with industry standards, ensuring compliance and promoting quality care delivery.
Patient Population / Client Focus

Your primary focus will be on older adults within a hospice care framework, addressing their complex emotional and psychological needs during a critical phase of life. Through careful assessment and individualized intervention, you will help clients navigate their feelings and experiences related to end-of-life issues, all within a safe and sensitive environment.

Qualifications
  • Master's degree in Social Work from an accredited institution is required.
  • A valid LCSW license in the state of Maryland is mandatory.
  • Demonstrable experience working with older adult populations, particularly in complex care settings.
  • Strong clinical and diagnostic skills, with a solid understanding of mental health principles.
  • Excellent communication and interpersonal skills to build rapport with clients and collaborate with team members.
  • A self-starter mentality, able to work independently while also being a constructive team player.
Preferred Experience
  • Experience with hospice or palliative care environments is highly desirable.
  • Familiarity with mental health regulations, documentation protocols, and utilization review processes.
  • Proficiency in using electronic health record (EHR) systems and telehealth platforms.
Compensation and Benefits

The compensation for this role ranges from $90,000 to $105,000 per year, commensurate with experience and qualifications. We offer a comprehensive benefits package that includes:

  • Competitive salary with periodic reviews.
  • Comprehensive health plans including Medical, Dental, and Vision coverage.
  • A 401(k) plan with employer matching and Flex Spending options.
  • Life insurance and coverage for short-term disability.
  • Generous paid time off and continuous professional development opportunities.
Career Growth Opportunities

At Desta Care Therapeutic, we prioritize the professional growth of our team members. You will have access to ongoing training, mentorship programs, and the chance to engage in leadership roles as you continue to develop your career in social work. We believe in fostering talent from within and encourage all employees to pursue their interests in specialized fields of practice.

Why Join Our Team

If you're seeking a fulfilling role that blends clinical expertise with compassionate care, Desta Care Therapeutic is the right place for you. By joining our team, you will be part of an organization that values your insights and fosters a culture of teamwork, respect, and appreciation. Together, we can make a significant impact on the lives of our clients and contribute to the advancement of mental health care.

Application Information

If you are passionate about social work and dedicated to enhancing the lives of those in hospice care, we invite you to apply today. Please submit your resume and a cover letter detailing your relevant experience and motivation for applying to this position. We look forward to connecting with candidates who share our commitment to exceptional client care.

Apply