ZipRecruiter

Log In

2

Full Time Cigna Utilization Review Jobs (NOW HIRING)

Prime Healthcare

Utilization Review Tech

Lynwood, CA · On-site

$21 - $24.45/hr

The Utilization review tech essentially works to coordinate the utilization review and appeals ... e. full-time or part-time. The current compensation range for this role is $21.00 to $24.45. The ...

New

Midland Health

Nurse Utilization Review

Midland, TX

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... SHIFT AND SCHEDULE Full Time, Monday - Friday; 8:00 AM - 5:00 PM ESSENTIAL FUNCTIONS/PERFORMANCE ...

Midland Health

Nurse Utilization Review

Midland, TX

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... SHIFT AND SCHEDULE Full Time, Monday - Friday; 8:00 AM - 5:00 PM ESSENTIAL FUNCTIONS/PERFORMANCE ...

Midland Health

Nurse Utilization Review

Midland, TX · On-site

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... SHIFT AND SCHEDULE Full Time, Monday - Friday; 8:00 AM - 5:00 PM ESSENTIAL FUNCTIONS/PERFORMANCE ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

next page

Showing results 1-20

All JobsFull Time Cigna Utilization Review Jobs

Full Time Cigna Utilization Review information

See salary details

$21

$42

$68

How much do full time cigna utilization review jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for full time 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 the difference between Full Time Cigna Utilization Review vs Full Time Cigna Claims Specialist?

AspectFull Time Cigna Utilization ReviewFull Time Cigna Claims Specialist
CertificationsTypically requires healthcare or insurance-related certificationsUsually requires claims processing or insurance certifications
Work EnvironmentReviewing medical records, assessing coverage, and determining medical necessityProcessing claims, verifying coverage, and resolving billing issues
Employer & Industry UsageUsed in healthcare insurance for utilization managementUsed in insurance claims processing departments

Full Time Cigna Utilization Review focuses on evaluating medical necessity and approving or denying healthcare services, while Full Time Cigna Claims Specialist handles claims processing and billing inquiries. Both roles are essential in healthcare insurance but differ in daily tasks and focus areas.

More about Full Time Cigna Utilization Review jobs
What cities are hiring for Full Time Cigna Utilization Review jobs? Cities with the most Full Time Cigna Utilization Review job openings:
What are the most commonly searched types of Cigna Utilization Review jobs? The most popular types of Cigna Utilization Review jobs are:
What states have the most Full Time Cigna Utilization Review jobs? States with the most job openings for Full Time Cigna Utilization Review jobs include:
What job categories do people searching Full Time Cigna Utilization Review jobs look for? The top searched job categories for Full Time Cigna Utilization Review jobs are:
Full Time Cigna Utilization Review jobs near you
Infographic showing various Full Time Cigna Utilization Review job openings in the United States as of June 2026, with employment types broken down into 66% Full Time, 17% Temporary, and 17% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Specialist

Utilization Review Specialist

BriteLife Recovery

Englewood, NJ • On-site

Full-time

Posted 26 days ago

Job description

) What you will be doing?
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at Britelife Recovery. This role ensures timely approvals and continued stay authorizations from insurance payers by effectively communicating clinical information and advocating for appropriate levels of care.
The UR Specialist works closely with clinical staff, admissions, medical providers, and third-party payers to support patient access to treatment and maintain financial viability for the organization. Success in this role requires strong clinical judgment, documentation skills, familiarity with ASAM criteria, and a working knowledge of insurance guidelines specific to behavioral health
What tasks are required?
  • Conduct initial and concurrent reviews for detox, residential, partial hospitalization (PHP), and intensive outpatient (IOP) levels of care.
  • Obtain prior authorizations and continued stay approvals from commercial and other payers by submitting timely clinical reviews and documentation.
  • Communicate clinical necessity of services based on ASAM criteria and DSM-5 diagnoses.
  • Track and document all insurance-related communications, decisions, and outcomes in the EHR and UR logs.
  • Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up-to-date clinical information for reviews.
  • Ensure treatment plans, progress notes, and assessments are completed on time and accurately reflect medical necessity.
  • Participate in multidisciplinary team meetings to stay informed on client progress and treatment goals.
  • Assist staff with proper documentation practices to support insurance justification and compliance.
  • Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols.
  • Monitor trends in denials, approvals, and length-of-stay metrics to support organizational performance improvement.
  • Assist in appeals and peer reviews by gathering required documentation and preparing clinical summaries.
  • Provide training and support to staff on documentation best practices related to utilization review.
  • Special projects as assigned

What we need from you?
  • Minimum of 2-3 years of experience in utilization review, case management, or insurance coordination in a behavioral health or substance use treatment setting.
  • Knowledge of ASAM criteria and levels of care for substance use and co-occurring disorders.
  • Familiarity with managed care principles, insurance authorizations, and payer requirements.
  • Bachelor's degree in Nursing, Social Work, Psychology, or a related field required; advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred.
  • Excellent organizational, communication, and time management skills.
  • Proficiency in Electronic Health Records (EHRs), insurance portals, and Microsoft Office tools.
  • Bachelor's degree in Nursing, Social Work, Psychology, or a related field required; advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred.
  • Experience or working knowledge with Collaborative MD and KIPU
  • Experience in detox and residential SUD programs.
  • Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna).
  • Strong clinical writing skills and familiarity with medical necessity language.
  • Ability to advocate for clients while balancing payer relationships and compliance.
  • Ability to lift up to 25 pounds.
  • Ability to walk up and down stairs during emergency drills or situations.

All ARS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. ARS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Apply