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Full Time Cigna Utilization Review Nurse Jobs (NOW HIRING)

Medix

Utilization Review Nurse

Fort Worth, TX · On-site

$38.46 - $43.27/hr

Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role involves analyzing billing data, documenting work, and adhering to HIPAA regulations. The successful ...

Moffitt

$77K - $117K/yr

Summary The Utilization Review Nurse is responsible for performing initial, concurrent, and retrospective utilization reviews to determine medical necessity, appropriate level of care, and continued ...

UHS

Utilization Review Nurse (RN)

Augusta, GA · On-site

Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...

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Full Time Cigna Utilization Review Nurse information

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

As of Sep 5, 2026, the average hourly pay for full time 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 does a full time Cigna utilization review nurse do?

A Full Time Cigna Utilization Review Nurse is responsible for evaluating medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities for Cigna insurance members. They review clinical information, apply evidence-based guidelines, and collaborate with healthcare providers to ensure members receive the right level of care. Their work helps manage healthcare costs while ensuring quality patient outcomes. This role typically involves reviewing patient records, conducting telephonic assessments, and making coverage determinations.

What are the key skills and qualifications needed to thrive as a full time Cigna utilization review nurse?

To excel as a Full Time Cigna Utilization Review Nurse, you need a valid RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of medical necessity guidelines such as InterQual or MCG is typically required. Exceptional communication, critical thinking, and organizational skills help nurses effectively coordinate with providers and advocate for patient care. These competencies are vital to ensure compliance, optimize resource use, and promote high-quality, cost-effective healthcare outcomes.

What are some common challenges faced by full time Cigna utilization review nurses, and how can they be managed?

Full Time Cigna Utilization Review Nurses often encounter challenges such as balancing productivity targets with the need for thorough, individualized patient assessments. Managing complex cases and coordinating with multiple providers can also be demanding. To manage these challenges, nurses can leverage Cigna’s robust clinical guidelines, maintain strong organizational skills, and communicate proactively with interdisciplinary teams. Continuous education and peer support groups within the company further help in navigating evolving healthcare regulations and improving decision-making confidence.
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Full Time Cigna Utilization Review Nurse jobs near you
Infographic showing various Full Time Cigna Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Utilization Review Nurse

Healthcare Support Staffing

Troy, MI • On-site

$33 - $37/hr

Full-time

Re-posted 26 days ago

Key responsibilities

  • Perform utilization review for Medicaid and Medicare members, including inpatient, skilled nursing, rehab, behavioral health, and home healthcare services.

  • Conduct daily reviews and evaluations of members requiring hospitalization or procedures, providing prior authorizations and concurrent reviews.

  • Assist with provider appeals, utilization reviews, and denial letters, ensuring services meet medical necessity, cost-effectiveness, and regulatory compliance.

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the RN Utilization Review Nurse position for you!


Company Job Description/Day to Day Duties:

  • Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare.
  • Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines
  • Provider appeals and Utilization reviews and assist with Denial Letters
  • Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team.
  • Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
  • Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care.


Hours for this Position:

  • Mon-Fri: 8:30am - 5pm


Advantages of this Opportunity:

  • Great salary between $33 - 37!
  • Great benefits!!!
  • Fun and positive work environment!
Qualifications

Minimum Education/Qualifications/Licensures:

  • Must be an RN
  • Utilization Review background in either Managed Care of Provider environment (at least one year)
  • Interqual experience (at least one year)
  • Also has a background in patient, skilled nurses facilities, rehab, and home healthcare.
  • Other basic computer skills necessary: Microsoft Office, Data Entry, etc.
  • Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
  • Great typing and data entry skills
Additional Information

Interested in being considered?

If you are interested in being considered for this position, please click the apply button below.  Or call John Wood 407-478-0332 ext 225

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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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