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Fulltime Cigna Utilization Review Nurse Jobs (NOW HIRING)

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

Gbmc

Bachelor of Science in Nursing (BSN) * Certification in Utilization Management and/or Care ... Two (2) years of Utilization Review and Case Management experience which includes utilization ...

New

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we're more than a health ...

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

Orange, CA · On-site

$38 - $53/hr

Job Summary Our client is seeking a Utilization Review Nurse responsible for managing the complete Utilization Management (UM) process, from admission through discharge planning. The primary goal is ...

Albanymed

Utilization Review Nurse

Albany, NY

$77K - $119K/yr

While performing utilization review identifies areas for clinical documentation improvement and ... Registered nurse with a New York State current license. Associate's degree required. Bachelor ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we're more than a health ...

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 ...

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 ...

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Fulltime Cigna Utilization Review Nurse information

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

As of Aug 18, 2026, the average hourly pay for fulltime 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 Fulltime Cigna Utilization Review Nurse vs Fulltime Cigna Case Manager?

AspectFulltime Cigna Utilization Review NurseFulltime Cigna Case Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentReviewing medical records, assessing insurance claimsCoordinating patient care, communicating with providers
Employer & IndustryHealth insurance, managed careHealth insurance, patient advocacy
Search & Comparison IntentFocus on utilization review rolesFocus on case management roles

While both roles require nursing credentials and work within health insurance companies like Cigna, the Utilization Review Nurse primarily evaluates medical necessity for coverage, whereas the Case Manager coordinates patient care and services. Understanding these differences helps job seekers find the role that best matches their skills and career goals.

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Fulltime Cigna Utilization Review Nurse jobs near you
Infographic showing various Fulltime Cigna Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Shannon Health

Big Spring, TX • On-site

Full-time

Re-posted 24 days ago

Job description

Job Summary
The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and reimbursement requirements of various commercial and government payers. This individual is responsible for performing a variety of concurrent and retrospective UM-related reviews and functions and for ensuring that appropriate data is tracked, evaluated, and reported. There will be interaction with providers, patient, and the care team for continued UM process. Further job duties will include Denial prevention, denial management, Implementation of process improvements to mitigate payer denials & improve front-end processes, Collaboration with internal Physician Advisor and external physician advisors regarding physician practices (particularly documentation deficiencies/admission practices). This individual identifies, develops, and provides orientation, and training, for appropriate staff and colleagues on an ongoing basis. He/she actively participates in process improvement initiatives, working with a variety of departments and multi-disciplinary staff. This individual maintains current and accurate knowledge regarding commercial and government payers and CIHQ regulations/guidelines/criteria related to UM. The UR Nurse effectively and efficiently manages a diverse workload in a dynamic regulatory environment. The UR Nurse is a member of, and provides support to, the hospital's UR Committee. He/she collaborates with multiple leaders at various levels throughout Shannon Health, for the purpose of supporting and improving the UM program.
Qualifications
Education
  • Required
    • High School Diploma, GED, or equivalent
    • Associate's degree in Nursing
  • Preferred
    • Bachelor's degree in Nursing

Experience:
  • Required
    • Five years of experience in Clinical Nursing
  • Preferred
    • Three years of experience in Inpatient Utilization Review

Certification/Licensure:
  • Required
    • Registered Nurse (RN), with authorization to practice in the State of Texas
  • Preferred
    • Accredited Case Manager (ACM) through ACMA
    • Certified Case Manager (CCM) through CCMC

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