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Cigna Utilization Review Jobs (NOW HIRING)

Cigna

Account Executive - Cigna Pharmacy - Remote

Participate in client engagements to review performance metrics and present a comprehensive suite ... Analyze pharmacy utilization trends to provide consultative recommendations and address client ...

GQR Global Markets

RN - Case Manager

Mission Viejo, CA · On-site

$2.0K - $2.1K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR Global Markets

RN Case Manager

Jackson, MS · On-site

$2.2K - $2.3K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR Global Markets

RN Case Manager

Prairie City, OR · On-site

$2.7K - $2.8K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR Global Markets

RN Case Manager

Fort Myers, FL · On-site

$1.7K - $1.8K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR Global Markets

RN - Case Manager

Largo, FL · On-site

$1.8K - $1.9K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR Global Markets

RN - Case Manager

Everett, MA · On-site

$2.9K - $3.0K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

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How much do cigna utilization review jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for cigna utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a Cigna Utilization Review?

A Cigna Utilization Review job involves evaluating medical treatments, procedures, and services to ensure they meet medical necessity and cost-effectiveness criteria. Utilization review specialists, typically nurses or healthcare professionals, assess patient records, verify insurance coverage, and collaborate with providers to determine appropriate care plans. They follow Cigna’s guidelines and policies to ensure compliance with healthcare regulations. This role helps manage healthcare costs while ensuring patients receive necessary and appropriate care.

What does a Cigna Utilization Review do?

A typical day in a Cigna Utilization Review position involves reviewing clinical documentation, evaluating requests for medical procedures or services, and determining coverage based on established guidelines and policies. Professionals in this role regularly interact with healthcare providers, clinicians, and internal teams to clarify cases and support care coordination. The work is primarily desk-based and may be remote or in an office setting, and it requires staying up-to-date with regulatory changes and healthcare best practices. This role provides insight into the intersection of care delivery and insurance, offering opportunities for growth into leadership, quality assurance, or clinical policy development.

What are the key skills and qualifications needed to thrive in Cigna Utilization Review?

To excel in a Cigna Utilization Review role, you typically need a background in nursing or a related healthcare field, with an active RN license and experience in clinical assessment and case management. Familiarity with utilization management software, health insurance policies, and medical coding systems such as ICD-10 and CPT is often required. Strong analytical thinking, attention to detail, and effective communication skills are crucial for evaluating medical necessity and collaborating with providers. These competencies ensure accurate determinations, support high-quality patient care, and help maintain compliance with regulatory standards.

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Cigna Utilization Review jobs near you
Infographic showing various Cigna Utilization Review job openings in the United States as of September 2026, with employment types broken down into 83% Full Time, 6% Part Time, and 11% Contract. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Software Engineering Advisor- Hybrid

Morris Plains, NJ • On-site, Remote

Cigna
Health Care and Social Assistance • 10K+ employees
Learn more about Cignaexternal

$148K - $186K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 27 days ago

Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 241 frontline employees who took The Breakroom Quiz

Job description

Cigna-Evernorth Services Inc. seeks a Software Engineering Advisor for the Morris Plains, NJ location to provide expert content and professional guidance on complex software engineering assignments and projects.

Responsibilities:

Analyze, design, develop, and implement solutions for Claims Adjudication and Drug Utilization Review systems.

Build solutions that integrate multiple technologies.

Conceive, plan, and deliver initiatives and advise functional leaders.

Part of a project team that delivers high-quality and complex solutions to clients that meet business needs.

Translate customer requirements into formal requirements and design documents.

Establish specific solutions and lead programming and testing efforts to meet client needs.

Responsible for the estimation of project, as well as coding and testing reviews.

Establish quality procedures for the team and monitor and audit projects to ensure quality.

Hybrid work schedule.

Qualifications:

Bachelor's degree in Computer Science, Computer Engineering or related field and 3 years of experience in any software engineering or software development role for mainframe technologies.

Must have experience with: Implementing business logic using COBOL;

Making code changes in COBOL to modify existing logic based on business requirements; Making code changes in COBOL to develop new functionality based on business requirements;

Processing real-time online business transactions on the mainframe through CICS;

Storing and processing business critical data in VSAM mainframe files; Storing and processing member and claim-related data in DB2 tables;

Loading business and member related data into mainframe tables through batch process controlled by JCL;

Java services for connecting web-based applications to the mainframe;

Accessing business rules and business data stored in DB2 tables using SQL;

Using Spring Boot-based microservices to connect web applications to the mainframe; Storing derived claim-related data in MongoDB;

Connecting cloud services to the mainframe through Kafka data pipelines; and,

Legacy IBM mainframe technologies including Endevor, IBM MQ, File-AID, and XPEDITOR.

Salary Range: $148,900-$186,100/year


If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 111,700 - 186,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.


At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.


About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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About Cigna

Sourced by ZipRecruiter

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Bloomfield, CT, US

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