... drug, utilization management, and third-party data. In this role you will work closely with ... Ability to peer review * Champions a culture of documentation and logging * Ability to own a ...
... drug, utilization management, and third-party data. In this role you will work closely with ... Ability to peer review * Champions a culture of documentation and logging * Ability to own a ...
... drug, utilization management, and third-party data. In this role you will work closely with ... Ability to peer review * Champions a culture of documentation and logging * Ability to own a ...
... drug, utilization management, and third-party data. In this role you will work closely with ... Ability to peer review * Champions a culture of documentation and logging * Ability to own a ...
Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)
Morrisville, NC · Remote
... appropriate utilization of both state and Medicaid funds. This position is full-time remote ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...
Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)
Morrisville, NC · Remote
... appropriate utilization of both state and Medicaid funds. This position is full-time remote ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...
Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)
Morrisville, NC · On-site +1
... appropriate utilization of both state and Medicaid funds. This position is full-time remote ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...
Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)
Morrisville, NC · On-site +1
... appropriate utilization of both state and Medicaid funds. This position is full-time remote ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...
MDS Coordinator (RN)
$33.75 - $40.75/hr
MDS Coordinator (RN) Full-Time | Exempt | Day Shift We are seeking a clinically strong and highly ... Medicare, and utilization review meetings • Ensure timely completion, validation, and ...
Quick apply
MDS Coordinator (RN)
$33.75 - $40.75/hr
MDS Coordinator (RN) Full-Time | Exempt | Day Shift We are seeking a clinically strong and highly ... Medicare, and utilization review meetings • Ensure timely completion, validation, and ...
MDS Coordinator (RN)
Durham, NC · On-site
$33.75 - $40.75/hr
) MDS Coordinator (RN) Full-Time | Exempt | Day Shift We are seeking a clinically strong and highly ... Medicare, and utilization review meetings • Ensure timely completion, validation, and ...
MDS Coordinator (RN)
Durham, NC · On-site
$33.75 - $40.75/hr
) MDS Coordinator (RN) Full-Time | Exempt | Day Shift We are seeking a clinically strong and highly ... Medicare, and utilization review meetings • Ensure timely completion, validation, and ...
RN Care Manager - Rex Case Management Services
Raleigh, NC · On-site
$35.87 - $51.57/hr
... case management, utilization review and discharge planning. The Care Manager must be highly ... Rex Case Management Services Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $35 ...
RN Care Manager - Rex Case Management Services
Raleigh, NC · On-site
$35.87 - $51.57/hr
... case management, utilization review and discharge planning. The Care Manager must be highly ... Rex Case Management Services Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $35 ...
Medical Director-Physical Health (Full-time Remote, North Carolina Based)
Morrisville, NC · Hybrid
$211K - $269K/yr
This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care coordination. This position ...
Medical Director-Physical Health (Full-time Remote, North Carolina Based)
Morrisville, NC · Hybrid
$211K - $269K/yr
This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care coordination. This position ...
Medical Director-Physical Health (Full-time Remote, North Carolina Based)
Smithfield, NC · Hybrid
$211K - $269K/yr
This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care coordination. This position ...
Medical Director-Physical Health (Full-time Remote, North Carolina Based)
Smithfield, NC · Hybrid
$211K - $269K/yr
This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care coordination. This position ...
Appeals Medical Director- Cardiology
Durham, NC · On-site
$247K - $446K/yr
This role enables associates to work virtually full-time, with the exception of required in-person ... when conducting utilization review or an appeals consideration and cannot be located on a US ...
Appeals Medical Director- Cardiology
Durham, NC · On-site
$247K - $446K/yr
This role enables associates to work virtually full-time, with the exception of required in-person ... when conducting utilization review or an appeals consideration and cannot be located on a US ...
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... Documents discharge planning interventions and utilization review activity according to department ...
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... Documents discharge planning interventions and utilization review activity according to department ...
Service Manager Full Time Opportunity Summary Description Intakes customer vehicles, notes problems ... current resource utilization. * Review work-in-progress to ensure quality and timeliness.
Service Manager Full Time Opportunity Summary Description Intakes customer vehicles, notes problems ... current resource utilization. * Review work-in-progress to ensure quality and timeliness.
Awarded 2024 Cigna Healthy Workforce Designation Gold Level Laborieprovidesequal employment ... Employment Type: Full time
Awarded 2024 Cigna Healthy Workforce Designation Gold Level Laborieprovidesequal employment ... Employment Type: Full time
Nursing Coordinator VAD - VAD Program
Chapel Hill, NC · On-site
$38.55 - $55.43/hr
Reviews patient resource utilization with administrative and clinical staff to identify areas for ... Lung Pre-Transplant Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $38.55 - $55 ...
Nursing Coordinator VAD - VAD Program
Chapel Hill, NC · On-site
$38.55 - $55.43/hr
Reviews patient resource utilization with administrative and clinical staff to identify areas for ... Lung Pre-Transplant Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $38.55 - $55 ...
Case Manager SE
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... case management and utilization review encouraged C. Licensure/Certification 1. Current ...
Case Manager SE
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... case management and utilization review encouraged C. Licensure/Certification 1. Current ...
Case Manager SE
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... case management and utilization review encouraged C. Licensure/Certification 1. Current ...
Case Manager SE
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Care Coordination Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details ... case management and utilization review encouraged C. Licensure/Certification 1. Current ...
RN Patient Logistics Access Coordinator- UNC Capacity Command Center
Chapel Hill, NC · On-site
$41.04 - $59/hr
... of entry case management, utilization review, and effective patient flow activities ... Capacity Command Center Work Type: Full Time Standard Hours Per Week: 36.00 Salary Range: $41.04 ...
RN Patient Logistics Access Coordinator- UNC Capacity Command Center
Chapel Hill, NC · On-site
$41.04 - $59/hr
... of entry case management, utilization review, and effective patient flow activities ... Capacity Command Center Work Type: Full Time Standard Hours Per Week: 36.00 Salary Range: $41.04 ...
RN Patient Logistics Access Coordinator - UNC Capacity Command Center West
Chapel Hill, NC · On-site
$41.45 - $59.58/hr
... of entry case management, utilization review, and effective patient flow activities ... Capacity Command Center Work Type: Full Time Standard Hours Per Week: 36.00 Salary Range: $41.45 ...
RN Patient Logistics Access Coordinator - UNC Capacity Command Center West
Chapel Hill, NC · On-site
$41.45 - $59.58/hr
... of entry case management, utilization review, and effective patient flow activities ... Capacity Command Center Work Type: Full Time Standard Hours Per Week: 36.00 Salary Range: $41.45 ...
Reviews staff utilization regularly and promptly addresses staff not meeting utilization goals ... UNAVAILABLEEmployment Type: FULL_TIME
Reviews staff utilization regularly and promptly addresses staff not meeting utilization goals ... UNAVAILABLEEmployment Type: FULL_TIME
Reviews staff utilization regularly and promptly addresses staff not meeting utilization goals ... UNAVAILABLEEmployment Type: FULL_TIME
Reviews staff utilization regularly and promptly addresses staff not meeting utilization goals ... UNAVAILABLEEmployment Type: FULL_TIME
Full Time Cigna Utilization Review information
See Raleigh, NC salary details
$20.80 - $25
2% of jobs
$25 - $29.21
9% of jobs
$32.09 is the 25th percentile. Wages below this are outliers.
$29.21 - $33.42
21% of jobs
The median wage is $36.82 / hr.
$33.42 - $37.62
23% of jobs
$37.62 - $41.83
13% of jobs
$45.10 is the 75th percentile. Wages above this are outliers.
$41.83 - $46.03
10% of jobs
$46.03 - $50.24
8% of jobs
$50.24 - $54.45
5% of jobs
$54.45 - $58.65
5% of jobs
$58.65 - $62.86
2% of jobs
$62.86 - $67.06
2% of jobs
$20
$41
$67
How much do full time cigna utilization review jobs pay per hour?
As of Jul 26, 2026, the average hourly pay for full time cigna utilization review in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 per hour, depending on experience, location, and employer.
What is the difference between Full Time Cigna Utilization Review vs Full Time Cigna Claims Specialist?
| Aspect | Full Time Cigna Utilization Review | Full Time Cigna Claims Specialist |
|---|---|---|
| Certifications | Typically requires healthcare or insurance-related certifications | Usually requires claims processing or insurance certifications |
| Work Environment | Reviewing medical records, assessing coverage, and determining medical necessity | Processing claims, verifying coverage, and resolving billing issues |
| Employer & Industry Usage | Used in healthcare insurance for utilization management | Used 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.
What are popular job titles related to Full Time Cigna Utilization Review jobs in Raleigh, NC? For Full Time Cigna Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
- Utilization Review Nurse
- Remote Utilization Management
- Utilization Management
- Remote Telephonic Nurse
- Night Utilization Review Nurse
- Cvs Health Utilization Management
- Evening Optum Health Utilization Review
- Utilization Review Physician
- Home Based Utilization Review Nurse
- No Experience Utilization Review Nurse
What job categories do people searching Full Time Cigna Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Full Time Cigna Utilization Review jobs in Raleigh, NC are:
- Remote Utilization Review
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- Remote Occupational Therapy Utilization Review
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- Temporary Medical Utilization Review Physician
- Utilization Review Salary
- Remote Aetna Utilization Review Nurse
- Authorization Utilization Review
- Internship Remote Utilization Review
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 22 days ago
Cigna Healthcare rating
8.4
Based on 237 frontline employees who took The Breakroom Quiz
27th of 890 rated healthcare providers
Job description
Summary
Using your knowledge of statistics, healthcare, and ML / AI you will build models to help identify opportunities for our pricing and underwriting partners. You will perform feature engineering, model development, and model monitoring / maintenance using a broad range of medical, prescription drug, utilization management, and third-party data. In this role you will work closely with leadership, data scientists, business stakeholders and engineering partners to deliver robust well-documented deliverables that will enhance our competitive position in the marketplace.
Responsibilities
Qualifications:
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 131,200 - 218,600 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 and paid holidays. 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.
Using your knowledge of statistics, healthcare, and ML / AI you will build models to help identify opportunities for our pricing and underwriting partners. You will perform feature engineering, model development, and model monitoring / maintenance using a broad range of medical, prescription drug, utilization management, and third-party data. In this role you will work closely with leadership, data scientists, business stakeholders and engineering partners to deliver robust well-documented deliverables that will enhance our competitive position in the marketplace.
Responsibilities
- Contribute to the development of comprehensive analytics that facilitate best in class pricing and underwriting
- Execute special projects that can improve Commercial Healthcare underwriting
- Utilize data science and advanced analytics to create actionable insights and recommendations for business leaders to advance Cigna's strategic objectives
- Regularly communicate work with business stakeholders and senior leadership
- Stay up to date on latest analytic tools and techniques and strategize how to leverage these tools to modernize our pricing/UW organizations
- Ensure solutions drive long term value while also ensuring they can integrate with current processes
- Test & Learn Pilots: collaborate with business leaders to design, launch and measure robust pilots to test new solutions
- Develop models that foster underwriting and actuarial advancement by aligning business problems to a potential solution like GLMs, Machine Learning, Clustering, LLMs or other advanced techniques
Qualifications:
- 5+ years direct Data Science experience in a healthcare related environment
- Strong background in stats, ML and model development
- Experience deploying ML/predictive models to prod/cloud env't
- Strong skills with Python, SQL, Git, Keras and TensorFlow
- Knowledge of common health care data e.g., claims, EHR, laboratory data
- Experience with best programming practices and writes clean, documented, and well-structured code
- Ability to peer review
- Champions a culture of documentation and logging
- Ability to own a project end-to-end e.g., scoping, ideation, dev, prod
- Ability to independently deliver clear and well developed presentations for both technical and business audiences
- Ability to create DS-specific project goals associated within high level project deliverables
- Ability to articulate timeline changes, rationale, and goals to meet deadlines moving forward
- Prefer MS or PhD in STEM related fields
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 131,200 - 218,600 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 and paid holidays. 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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