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Entry Level Cigna Utilization Review Nurse Jobs (NOW HIRING)

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 ...

UK St Claire

Utilization Review Nurse

Morehead, KY · On-site +1

Supports utilization review processes by planning, analyzing data, and setting goals to ensure ... Education Requirement Bachelor's degree in nursing, or a related field Experience Requirement 2+ ...

UK St Claire

Supports utilization review processes by planning, analyzing data, and setting goals to ensure ... Generates and interprets reports for physicians, nursing, and ancillary services. Coordinates with ...

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Entry Level Cigna Utilization Review Nurse information

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

As of Jul 20, 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 Entry Level Utilization Review Nurses at Cigna, 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

Utilization Review Nurse

Integrated Resources INC

North Charleston, SC

Other

Posted 22 days ago

Job description

Company Description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.

Job Description

Responsible for conducting timely reviews of all requests for services required to meet medical necessity criteria to include reviewing pre-certification for outpatient and inpatient services

Applying criteria to inpatient admissions and performing concurrent review functions, identifying discharge planning needs and referral of members to case management.

Evaluates clinical information submitted by providers against plan review criteria and benefit guidelines

Utilizes clinical information to determine if criteria for medical necessity and benefit guidelines are met

Utilizes professional judgment to determine if additional information is required, then follows through to obtain additional information prior to making a decision

Documents all pertinent case information and dispositions for approvals and denials

Refers all cases failing to meet interqual medical necessity criteria to Medical Director for review and final determination

Communicates with providers to initiate/coordinate outpatient services/discharge planning needs for members

Acts as a liaison to assure services are provided in the least restrictive, most cost effective and clinically appropriate setting

Works with the Utilization Management Manager, the Medical Director and providers to ensure that complete medical information is available to allow utilization management decisions to be made within The Plan's standards for decision making

Identifies potential members who may benefit from case management services and facilitates referral to the program

Identifies and resolves any problems that could interfere with provider's continuity and coordination of care of members and refers unresolved problems to Manager

Creates and maintains monthly reports on inpatient activities

Performs other related duties and projects as assigned

Adheres to ACFC policies and procedures

Supports and carries out our Mission & Values.

Qualifications

Associates RN degree required, Bachelor's degree preferred

Two years of experience in managed care quality assurance or utilization review

RN must have two years of experience in an acute care hospital.

Additional Information

Thanks

Warm Regards

Ricky Bansal

732-429-1925

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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