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Cigna Utilization Review Remote Jobs (NOW HIRING)

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

silvercross

Utilization Review Nurse

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

Charlie Health

Utilization Review Specialist

Nashville, TN · Remote

$62K - $70K/yr

Knowledge of utilization review processes, medical necessity criteria, and healthcare regulations ... REMOTE Please note that this role is not available to candidates in Alaska, Maine, Washington DC ...

KYYBA

Be Seen First

Remote Utilization Review RN

Detroit, MI · Remote

$35 - $39/hr

Utilization Review RN Contract Duration: 12+ months Job Location: 100% REMOTE License Requirements: MI Registered Nurse License Mandatory Requirements to Apply * Active, unrestricted Michigan ...

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

As of Sep 13, 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 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.

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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 September 2026, with employment types broken down into 71% Full Time, and 29% Contract. Highlights an 100% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.

Utilization Review Nurse

Plano, TX • Remote

Bracane Co
Professional, Scientific, and Technical Services • 1 - 10 employees
Learn more about Bracane Coexternal

Full-time

Re-posted 20 hours ago

Job description

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***

JOB DESCRIPTION:

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.

JOB RESPONSIBILITIES:

  • This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions.
  • Collects clinical and non-clinical data.
  • Verifies eligibility.
  • Determines benefit levels in accordance to contract guidelines.
  • Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.

JOB QUALIFICATIONS (Required):

  • Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations.
  • 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.
  • Knowledge of medical terminology and procedures.
  • Verbal and written communication skills.

JOB QUALIFICATIONS (Preferred):

  • MCG or InterQual experience
  • Utilization management experience

LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin Counties).

POSITION: 6-month assignment