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Cigna Utilization Review Remote Jobs in Baton Rouge, LA

Imh

RN Care Manager - Inpatient

New Roads, LA · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

RN Care Manager - PRN

New Roads, LA · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

RN Care Manager

New Roads, LA · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

ABB

Utility Sales Support

LA · Remote

$17.75 - $23.25/hr

While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred

All JobsCigna Utilization Review JobsCigna Utilization Review Remote JobsCigna Utilization Review Remote Jobs in Baton Rouge, LA

Cigna Utilization Review Remote information

See Baton Rouge, LA salary details

$15

$30

$51

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

As of Aug 21, 2026, the average hourly pay for cigna utilization review remote in Baton Rouge, LA is $30.67, according to ZipRecruiter salary data. Most workers in this role earn between $21.49 and $38.99 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 Baton Rouge, LA?

The most popular types of Cigna Utilization Review jobs in Baton Rouge, LA are:

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

What job categories do people searching Cigna Utilization Review Remote jobs in Baton Rouge, LA look for?

The top searched job categories for Cigna Utilization Review Remote jobs in Baton Rouge, LA are:

Cigna Utilization Review Remote jobs near you
Infographic showing various Cigna Utilization Review Remote job openings in Baton Rouge, LA 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, with an average salary of $63,794 per year, or $30.7 per hour.

Care Coordinator RN remote work: Baton Rouge or New Orleans

eQHealth Solutions

Baton Rouge, LA • Remote

Full-time

Re-posted 11 days ago

Job description

  • Performs care coordination services for assigned recipients who are eligible for home health services (Home Health Visits, PPEC, Personal Care Services and/or Private Duty Nursing Services etc. based on contract requirements).
  • Uses discretion to approve/validate UR or forward to 2nd level reviewer. Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
  • Completes prior authorizations as appropriate in a timely manner.
  • Conducts an initial survey to recommend appropriate (home health assessment) for the recipient, unless this has already been done during the current fiscal year
  • Conducts a home and/or PPEC visit as needed or if contract requirement
  • Schedules and convenes initial face-to-face meeting in the recipient’s home and/or PPEC comprised of the recipient (if able) and the parent or legal guardian.
  • Assesses, plans, implements, monitors and evaluates the options and services required to meet the recipient’s health care needs.
  • Documents recipient’s assessment findings, actions, and outcomes.
  • Documents all communication, interventions and follow up tasks in the Care Coordination System within one (1) business day of each intervention and/or encounter.
  • Identifies patient care issues and makes recommendations on patient care issues.
  • Collaborates with the parent or legal guardian and healthcare team to arrange for identified home care needs.
  • Responsible for maintaining regular monthly contact (telephonically or face-to-face) with the recipient and the recipient’s parent or legal guardian.for purpose of updating Plan of Care (POC), resolving issues and identifying additional issues
  • As part of the multidisciplinary team, regularly meets with the team and contributes to the development of a comprehensive plan of care based on the needs of the recipient and recipient’s parent or legal guardian.
  • Evaluates and modifies recipient’s the plan of care as needed.  Regularly communicates changes to the recipient’s parent or legal guardian, healthcare team, and other agencies involved in the recipient’s care.
  • Monitors assigned caseload eligibility status on a monthly basis, based on their status in MMIS.
  • Completes a Staffing Tool (Freedom of Choice) any time a parent or legal guardian expresses the desire to reconsider a recipient’s placement into a Skilled Nursing Facility
  • Follow guidelines for additional required calls and visits for Skilled Nursing Facility (SNF) transitions to community settings for six (6) months.
  • Functions as a resource to the community.
  • Manages daily workload associated with quality review process, including facilitation of case assignments and follows up to ensure that all cases requiring additional assistance or care coordination are completed within timelines required by contract.
  •  Prioritizes and addresses requests and assignments in a professional manner to develop cooperative relationships to ensure that customer confidentiality is assured.
  • Provides courteous and prompt service to all internal and external customers at all times.
  • Attends staff meetings and continuing education sessions and will assist with learning opportunities as needed.
  • Participates in special projects, as needed.
  • Assists with the implementation of quality improvement initiatives.
  • Performs other duties as assigned.

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