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Cigna Utilization Review Remote Jobs in Rochester, NY

While this is a remote position, candidates must reside in or be willing to relocate to one of the ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

... reviews Reports key performance indices (KPI) for Operations, analyzes variances and provides ... This position is a remote role; however, we are seeking candidates who reside within reasonable ...

Cigna Utilization Review Remote information

See Rochester, NY salary details

$15

$31

$52

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

As of Aug 4, 2026, the average hourly pay for cigna utilization review remote in Rochester, NY is $31.51, according to ZipRecruiter salary data. Most workers in this role earn between $22.07 and $40.10 per hour, depending on experience, location, and employer.

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 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 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 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 most commonly searched types of Cigna Utilization Review jobs in Rochester, NY? The most popular types of Cigna Utilization Review jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Cigna Utilization Review Remote jobs? Cities near Rochester, NY with the most Cigna Utilization Review Remote job openings:
Infographic showing various Cigna Utilization Review Remote job openings in Rochester, NY as of June 2026, with employment types broken down into 1% As Needed, 95% Full Time, 1% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,550 per year, or $31.5 per hour.

LCSW Clinical Supervisor - Remote

Athena

Rochester, NY • Remote

$60 - $65/hr

Part-time

Re-posted 22 days ago


Job description

While this is a remote position, candidates must reside in or be willing to relocate to one of the following states prior to their start date:

Colorado, Connecticut, District of Columbia (Washington, D.C.), Florida, Massachusetts, Maryland, North Carolina, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington

Athena Mental Health is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges.  We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities.
 
Here at Athena, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our clients’ overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. 
 
Are You a Good Fit For Us?
We are currently seeking professional and compassionate Clinical Supervisors to join our growing team. Flexible hours are provided with the need of one weekend day and some evenings. In-person and telehealth sessions are conducted by our clinicians.
Responsibilities
  • Provide weekly clinical supervision to therapists as assigned, and document supervision sessions in a timely manner
  • Complete and maintain NYS licensure paperwork for supervisees as applicable
  • Assist with the development and facilitation of clinical training for staff in partnership with the leadership team
  • Work with the Clinical Director to cover administrative tasks as needed, including performance management of assigned therapists when necessary
  • Perform ongoing review of high-risk cases and provide clinical solutions as appropriate
  • Engage in the Utilization Review process for assigned cases every month
  • Respond to clinical crises and other clinical issues brought forward by supervisees
  • Help develop and improve clinical policies and procedures on an ongoing basis to support overall success of the program
  • Maintain a reduced caseload of therapy clients; complete all required clinical documentation promptly, including comprehensive assessments, treatment plans, and progress notes
Qualifications
  • NYS Independently Licensed Mental Health Provider (PhD, LCSW, LCSW-R, etc.)
  • Leadership experience in a mental health clinic setting
  • Bilingual in English and Spanish is preferred, but not required 
  • Previous experience using computerized appointment scheduling systems and/or electronic Medical Record Systems
  • Knowledgeable in NYS OMH Outpatient Clinic regulations
  • Knowledgeable in HIPAA Regulations
This is a fee-for-service role where you are compensated at a base rate per supervisory session.
Working Conditions
This position will be located at either the Manhattan office at 33 West 60th Street, New York, NY 10023, Suite 600, the Bronx office at 2825 Third Avenue, Suite 402, Bronx, NY 10455, 1299 Portland Ave, Suite 1, Rochester, NY 14621, or remotely. This is a professional work environment where a computer, desk, chair, and office supplies will be essential.
 
Physical Requirements
The physical demands described here are representative of those that must be met by an employee in order to successfully perform the essential functions of the role above. While performing the duties of this job, the employee is regularly required to hear and speak on the phone or through virtual telehealth sessions conducted on a computer throughout the day, stand and sit for an extended period of time and be able to write and answer emails in addition to carrying objects no greater than 25 pounds, when needed.
 
Direct Reports
This position has direct reports.
 
Athena is an Equal Opportunity Employer.
 
Note: We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions. 

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.