ZipRecruiter

Log In

2

Entry Level Cigna Utilization Review Nurse Jobs (NOW HIRING)

University of Utah

Utilization Review Nurse

Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...

silvercross

Utilization Review Nurse

New Lenox, IL

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Job Summary Our client is seeking a Utilization Review Nurse. This role involves managing the full lifecycle of Independent Review Organization (IRO) cases, ensuring compliance with regulatory ...

previous pagenext page

Showing results 21-40

All JobsCigna Utilization Review Nurse JobsEntry Level Cigna Utilization Review Nurse Jobs

Entry Level Cigna Utilization Review Nurse information

See salary details

$21

$42

$68

How much do entry level cigna utilization review nurse jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for entry level cigna utilization review nurse 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 the difference between Entry Level Cigna Utilization Review Nurse vs Entry Level Case Manager?

AspectEntry Level Cigna Utilization Review NurseEntry Level Case Manager
CertificationsRN license, possibly AHC or Cigna-specific trainingRN license, case management certification (e.g., CCM)
Work EnvironmentInsurance company, healthcare setting, review teamsHealthcare facilities, community agencies, insurance companies
Job FocusReview medical necessity, approve or deny coverageCoordinate patient care, arrange services, support patient needs
Common UsageUsed in health insurance, utilization managementUsed in patient advocacy, care coordination

While both roles require healthcare knowledge and RN licensure, the Entry Level Cigna Utilization Review Nurse primarily focuses on reviewing medical necessity for insurance coverage, whereas the Entry Level Case Manager concentrates on coordinating patient care and services. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

What are some common challenges faced by an entry level Cigna utilization review nurse, and how can they be addressed?

Entry Level Utilization Review Nurses at Cigna often encounter challenges such as managing high caseloads, staying up-to-date with evolving healthcare guidelines, and balancing administrative tasks with patient advocacy. Successfully navigating these challenges involves strong organizational skills, effective communication with multidisciplinary teams, and continuous learning through Cigna’s training programs. Building relationships with more experienced colleagues can provide valuable mentorship and support as you grow in the role.

What does an entry level Cigna utilization review nurse do?

An Entry Level Cigna Utilization Review Nurse is responsible for reviewing patient medical records to determine the medical necessity and appropriateness of healthcare services and procedures. They work with physicians, healthcare providers, and insurance teams to ensure that patients receive proper care while managing healthcare costs. This role involves assessing clinical information, applying Cigna’s guidelines, and communicating decisions to patients and providers. Entry level nurses in this position typically receive training in Cigna’s protocols and may work under the supervision of more experienced nurses.

What are the key skills and qualifications needed to thrive as an entry level Cigna utilization review nurse, and why are they important?

To thrive as an Entry Level Cigna Utilization Review Nurse, you need a registered nursing license, clinical knowledge, and an understanding of healthcare regulations and medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and insurance review systems is typically required. Strong analytical thinking, attention to detail, and effective communication skills help nurses collaborate with providers and advocate for patients. These skills ensure accurate assessments, regulatory compliance, and quality patient outcomes within the managed care environment.
What cities are hiring for Entry Level Cigna Utilization Review Nurse jobs? Cities with the most Entry Level Cigna Utilization Review Nurse job openings:
What are the most commonly searched types of Cigna Utilization Review Nurse jobs? The most popular types of Cigna Utilization Review Nurse jobs are:
What states have the most Entry Level Cigna Utilization Review Nurse jobs? States with the most job openings for Entry Level Cigna Utilization Review Nurse jobs include:
Entry Level Cigna Utilization Review Nurse jobs near you

Utilization Review Nurse

University of Utah

Salt Lake City, UT • On-site

Other

Re-posted 18 days ago

University Of Utah rating

7.2

Company rating: 7.2 out of 10

Based on 159 frontline employees who took The Breakroom Quiz

382nd of 617 rated colleges and universities

Job description

Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
  • Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
  • Communication to third-party payers for initial and concurrent clinical review.
  • Reviews patient chart to ensure patient continues to meet medical necessity.
  • Documentation of all actions and information shared with care team members or third-party payer.
  • Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
  • Discusses with physicians the appropriateness of resource utilization.
  • Tracks length of stay (LOS) and resource utilization to identify at risk patients.
  • Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
  • Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
  • Participant in UR Committee as needed.
  • Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
  • Prepares appeals on denied cases when appropriate.
  • At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
  • Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
  • Ability to perform the essential functions of the job as outlined above.
  • Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
  • Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
  • The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
  • Ability to work autonomously and as a team member.
Qualifications
Required
  • One year Utilization Review or Case Management experience.
Licenses Required
  • Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
* Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
  • Basic Life Support Health Care Provider card.
  • Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes.
  • Utilization Review Certification designation.
  • Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.

Physical Requirements
Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing, Walking

What University Of Utah employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

University of Utah logo

About University of Utah

Sourced by ZipRecruiter

The University of Utah is the state’s flagship institution of higher education, with 18 schools and colleges, more than 100 undergraduate majors and graduate programs, and an enrollment of more than 38,000 students. It is a member of the Association of American Universities—an invitation-only, prestigious group of 71 leading research institutions. The U is advancing a new national model for higher education that delivers societal impact through education, research, health care, and community service, while making social, economic, and cultural contributions that improve lives across Utah and around the world.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Salt Lake City, UT, US

Year founded

1850

View All University of Utah Jobs

Apply