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Cigna Utilization Review Remote Jobs in Spring Hill, FL

LIBERTY DENTAL

Senior Staff Dentist

Tampa, FL · On-site +1

$175K - $185K/yr

Conduct retrospective utilization reviews and support provider behavior change initiatives ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...

Monogram Health

Market Physician Executive

Tampa, FL · Remote

Review and approve APP, RN, SW, and PharmD plans of care, and appropriate and timely patient ... utilization, pharmacological prescribing and therapy management, multi-specialty platform, and ...

Risk Strategies

Senior Employee Benefits Analyst

Tampa, FL · On-site +1

$68K - $89K/yr

*Please Note: This is remote position but based out of Tampa, FL * The Senior Employee Benefits ... Evaluate claims experience, utilization trends, and financial performance to identify risks ...

Risk Strategies

Senior Employee Benefits Analyst

Tampa, FL · Remote

$68K - $89K/yr

*Please Note: This is remote position but based out of Tampa, FL *The Senior Employee Benefits ... Evaluate claims experience, utilization trends, and financial performance to identify risks ...

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Cigna Utilization Review Remote information

See Spring Hill, FL salary details

$13

$27

$45

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

As of Aug 11, 2026, the average hourly pay for cigna utilization review remote in Spring Hill, FL is $27.10, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $34.47 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 popular job titles related to Cigna Utilization Review Remote jobs in Spring Hill, FL? For Cigna Utilization Review Remote jobs in Spring Hill, FL, the most frequently searched job titles are:
What job categories do people searching Cigna Utilization Review Remote jobs in Spring Hill, FL look for? The top searched job categories for Cigna Utilization Review Remote jobs in Spring Hill, FL are:
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Cigna Utilization Review Remote jobs near you

Behavioral Health Care Advocate - UM - Remote

UnitedHealth Group

Tampa, FL • On-site, Remote

$60K - $107K/yr

Full-time

Retirement

Re-posted 18 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

186th of 887 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Optum family of businesses, is seeking a Behavioral Health Care Advocate to join our team. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone.
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
The Strategic Outpatient Engagement & Management (STEM) Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community-based treatment setting.
This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm CST schedule
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Focus on outpatient commercial, Medicaid and Medicare behavioral health services
  • Conducting outpatient reviews to determine appropriate care
  • Assessing if member care meets coverage guidelines
  • Shaping member treatment in partnership with providers to ensure best practices
  • Administering benefits and reviewing treatment plans

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Active, unrestricted, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling with 2+ years of experience in behavioral health
  • Active, unrestricted independent licensure in state of residence
  • 2+ years of experience in a behavioral health setting
  • Outpatient psychotherapy and community-based treatment experience
  • Proven MS Office proficiency (Word, Excel, Outlook, Internet)
  • Distraction-free space in home to use as a home office
  • Access to high-speed internet (DSL or Cable)

Preferred Qualifications:
  • 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
  • Experience working with EMRs (electronic medical records)
  • Experience in managed care
  • Experience conducting clinical review to determine appropriate levels of care
  • Demonstrated telephonic/office-based experience
  • Telephone queue experience
  • Utilization review/management experience

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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