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Cigna Utilization Review Remote Jobs (NOW HIRING)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

Medix

Utilization Review Nurse - Remote

Tempe, AZ · On-site +1

$40 - $45/hr

Job Summary Our client is seeking a Utilization Review Nurse to perform frequent case reviews, check medical records, and communicate with care providers regarding treatment as needed. The nurse will ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua ...

VIVA USA INC

Utilization Review Nurse

Albuquerque, NM · On-site +1

Remote position in any state except, NY, CA, HI, or AK Summary This Position Is Responsible For ... Review Service Requests, Collect Clinical And Non-Clinical Data, Verify Eligibility, Determine ...

Medica

Utilization Review III

$70K - $120K/yr

The Utilization Review III position is responsible for the review, investigation, and resolution of ... This position is a Remote role. To be eligible for consideration, candidates must have a primary ...

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Cigna Utilization Review Remote information

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$15

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$53

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

As of Jun 20, 2026, the average hourly pay for cigna utilization review remote in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 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, and why are they important?

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 is remote utilization review?

Remote utilization review is a process where healthcare professionals evaluate the necessity, appropriateness, and efficiency of medical services and treatments remotely, often using electronic health records and telecommunication tools. In roles like Cigna Utilization Review, employees assess patient cases from home to ensure proper care and cost management, typically requiring knowledge of medical guidelines and insurance policies.

Can you work remotely for Cigna from anywhere?

Cigna Utilization Review remote positions typically require employees to work within specific regions or states due to licensing and compliance requirements. While some roles may offer full remote flexibility, candidates should verify the location requirements during the application process or with the employer directly.

How to make $80,000 a year working from home?

A Cigna Utilization Review remote position can offer a salary of around $80,000 annually, especially with experience, relevant certifications, and strong utilization review skills. Increasing earnings may involve gaining specialized knowledge, working overtime, or advancing to senior roles within the company. Remote healthcare roles often require good communication skills and familiarity with medical records and insurance processes.

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 position?

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.

Is Cigna a good company to work for remotely?

Cigna offers remote positions such as Utilization Review roles that typically provide flexible schedules and the ability to work from home. Employees generally report positive experiences with company support, though individual experiences may vary based on team and role specifics.
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Cigna Utilization Review Remote jobs near you
Infographic showing various Cigna Utilization Review Remote job openings in the United States as of June 2026, with employment types broken down into 95% Full Time, 1% Temporary, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.
Utilization Review Technician III

Utilization Review Technician III

Prime Healthcare Management Inc

Ontario, CA • On-site, Remote

$23.15 - $30.03/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Prime Healthcare rating

6.3

Company rating: 6.3 out of 10

Based on 270 frontline employees who took The Breakroom Quiz

666th of 873 rated healthcare providers

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation's leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! 

Responsibilities

The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. This position will also serve as a liaison and own the coordination with other UR techs in the team while being responsible for coordinating phone calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The Utilization review tech will further support the department needs for Release of Information through faxing and mailing, discharge coordination or other duties as assigned.

Qualifications
  • Bachelor's degree or four years of relevant experience required.
  • Microsoft office proficiency.
  • Good communication skills

    • Preferred qualifications:

  • Completion of a medical terminology course; preferred.
  • Knowledge of HIPAA regulations preferred.
    • Pay Transparency

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.15 to $30.03. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment StatusFull TimeShiftDaysEqual Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

     Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Employment Type: FULL_TIME

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