ZipRecruiter

Log In

2

Cigna Utilization Review Remote Jobs in Houston, TX

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Compensation Disclosure The base salary for this position is $65,000 [LVN/LPN], $75,000 [RN] ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

S. • Minimum of two (2) years experience in utilization review, case management, or clinical ... Remote Compensation Disclosure The base salary for this position is $65,000 [LVN/LPN], $75,000 [RN] ...

YO AI Labs

Hospitalist Physician - Remote

Houston, TX · 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 ...

Dane Street, LLC

Certified Professional Coder

Houston, TX · Remote

$21.75 - $29/hr

Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

SUN Behavioral Houston

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

Demonstrates understanding of utilization review process to include treatment criteria and precertification payor to obtain initial authorization of care and document same with pass to the ...

next page

Showing results 1-20

All JobsCigna Utilization Review JobsCigna Utilization Review Remote JobsCigna Utilization Review Remote Jobs in Houston, TX

Cigna Utilization Review Remote information

See Houston, TX salary details

$14

$30

$51

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

As of Sep 5, 2026, the average hourly pay for cigna utilization review remote in Houston, TX is $30.50, according to ZipRecruiter salary data. Most workers in this role earn between $21.35 and $38.80 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 Houston, TX?

The most popular types of Cigna Utilization Review jobs in Houston, TX are:

What are popular job titles related to Cigna Utilization Review Remote jobs in Houston, TX?

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

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

The top searched job categories for Cigna Utilization Review Remote jobs in Houston, TX are:

What cities near Houston, TX are hiring for Cigna Utilization Review Remote jobs?

Cities near Houston, TX 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 Houston, TX as of August 2026, with employment types broken down into 86% Full Time, and 14% Contract. Highlights an 100% Remote job distribution, with an average salary of $63,445 per year, or $30.5 per hour.

Registered Nurse - Utilization Review - RNUR 26-10215

Compu-Vision - South

Houston, TX • Remote

$1.9K - $2.1K/wk

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Job Title: Registered Nurse – Utilization Review

Job Location: Fort Myers, FL

Work Arrangement: Remote

Duration: 13 Weeks

Compensation: $1,900–$2,100 Gross Weekly (Based on Experience)

Shift: Day Shift

Schedule:

  • Monday–Friday
  • 8:00 AM – 4:30 PM
  • 40 Hours Per Week

Position Type: Contract

Work Setting: Remote

Position Overview

We are seeking an experienced Registered Nurse (RN) – Utilization Review/Utilization Management for a 13-week remote contract assignment. The RN will review clinical information and medical records to support appropriate levels of care, medical necessity, resource utilization, and positive patient outcomes.

The ideal candidate will have provider-side utilization management experience, strong clinical judgment, excellent computer skills, and hands-on experience with Epic and DragonFly. Candidates must be comfortable working independently in a remote environment while maintaining productivity, accuracy, and quality standards.

Responsibilities
  • Perform utilization review and utilization management activities.
  • Review patient medical records, clinical documentation, and treatment information.
  • Assess medical necessity and appropriateness of level of care.
  • Collaborate with healthcare providers regarding patient care and utilization needs.
  • Communicate effectively with providers and members of the interdisciplinary care team.
  • Utilize DragonFly as the primary utilization management platform.
  • Accurately and promptly document utilization reviews and clinical determinations.
  • Navigate and document within the Epic EMR.
  • Support appropriate resource utilization and optimal patient outcomes.
  • Work independently in a remote environment while meeting productivity and quality expectations.
  • Float to other affiliated campuses as required based on staffing needs; travelers may be expected to float first when coverage is needed.
  • Perform other utilization management duties as assigned.
Required Qualifications Licensure
  • Active Registered Nurse (RN) license required.
Experience
  • Minimum 2 years of relevant nursing experience.
  • Provider-side utilization management experience required.
  • Candidates with exclusively payer-side utilization management experience do not meet the requirement.
  • Previous remote-work experience preferred.
  • Prior travel nursing experience highly preferred.
Technical Skills
  • DragonFly experience required.
  • Epic EMR experience required.
  • Strong computer literacy and clinical documentation skills.
  • Ability to efficiently navigate multiple electronic systems while working remotely.
Certifications
  • CCM or CMCN certification required.
Education
  • Degree accreditation must be verified, or candidate must have at least 5 years of relevant experience.