Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Quick apply
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Quick apply
Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
Data Science, AI Compute Strategy, Canada
Toronto, ON · On-site +1
We are open to candidates in Canada, either hybrid or remote. Responsibilities * Build analytical ... Analyze GPU demand, utilization, and unit economics to identify opportunities to improve ...
Data Science, AI Compute Strategy, Canada
Toronto, ON · On-site +1
We are open to candidates in Canada, either hybrid or remote. Responsibilities * Build analytical ... Analyze GPU demand, utilization, and unit economics to identify opportunities to improve ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Quick apply
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Quick apply
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Lead Infrastructure Engineer
Toronto, ON · Remote
CA$220K - CA$260K/yr
This is a fully remote position that offers a competitive salary range of $220,000 to $260,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Lead Infrastructure Engineer
Toronto, ON · Remote
CA$220K - CA$260K/yr
This is a fully remote position that offers a competitive salary range of $220,000 to $260,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Delivery Director
Toronto, ON · On-site +1
Ensure delivery performance, resource utilization, and profitability align with contractual ... Represent MiraCloud in executive-level customer discussions, implementation reviews, and delivery ...
Delivery Director
Toronto, ON · On-site +1
Ensure delivery performance, resource utilization, and profitability align with contractual ... Represent MiraCloud in executive-level customer discussions, implementation reviews, and delivery ...
Infrastructure Engineer
Toronto, ON · Remote
CA$140K - CA$190K/yr
This is a fully remote position that offers a competitive salary range of $140,000 to $190,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Infrastructure Engineer
Toronto, ON · Remote
CA$140K - CA$190K/yr
This is a fully remote position that offers a competitive salary range of $140,000 to $190,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Cigna Utilization Review Remote information
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?
| Aspect | Cigna Utilization Review Remote | Cigna Medical Reviewer |
|---|---|---|
| Credentials | RN or licensed healthcare professional | RN or licensed physician |
| Work Environment | Remote, telehealth setting | Remote or onsite, clinical setting |
| Employer & Industry | Cigna, health insurance industry | Cigna, healthcare and insurance industry |
| Primary Focus | Review of insurance utilization for appropriateness | Clinical 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 popular job titles related to Cigna Utilization Review Remote jobs in Toronto, ON?
For Cigna Utilization Review Remote jobs in Toronto, ON, the most frequently searched job titles are:
What job categories do people searching Cigna Utilization Review Remote jobs in Toronto, ON look for?
The top searched job categories for Cigna Utilization Review Remote jobs in Toronto, ON are:
- Remote Dental Utilization Review
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Healthcare Workflow Specialist - Fully Remote | Upto $80/hr
Toronto, ON • Remote
Mercor
CA$80/hr
Full-time
Re-posted 27 days ago
Job description
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.
Position: Registered Nurses (Data labelling and training)
Type: Contract
Compensation: $60–$80/hour
Location: Remote
Role Responsibilities
- Review and assess clinical documentation for accuracy, completeness, and quality.
- Analyze healthcare workflows and recommend process improvements.
- Interpret patient records and clinical notes to support product development.
- Identify documentation gaps, inconsistencies, and edge cases.
- Collaborate with product, engineering, and operations teams to refine AI-driven healthcare tools.
- Ensure adherence to healthcare regulations, policies, and best practices.
Qualifications
Must-Have
- Active Registered Nurse (RN) license.
- 3–5+ years of clinical nursing experience.
- Strong understanding of clinical documentation and healthcare workflows.
- Experience working with EHR systems (Epic, Cerner, Meditech, etc.).
- Excellent analytical, communication, and problem-solving skills.
Preferred
- Experience in CDI, case management, utilization review, or quality improvement.
- Exposure to healthcare technology, AI tools, or digital health products.
- Ability to collaborate effectively with cross-functional teams.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
- For any help or support, reach out to: support@mercor.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.