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Part Time Cigna Utilization Review Nurse Jobs (NOW HIRING)

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

UHS

PT UTILIZATION REVIEW COORDINATOR

Jacksonville, FL · On-site

PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...

LifeBridge Health

Nurse

Randallstown, MD · On-site

Utilization Review Nurse RN - NE ~ NORTHWEST HOSPITAL ~NW CARE MANAGEMENT ~Part-time - Weekends - Weekend shifts - 8:00am-4:30pm ~RN OTHER ~This is an EVERY Saturday and Sunday role LifeBridge Health ...

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Part Time Cigna Utilization Review Nurse information

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

As of Aug 10, 2026, the average hourly pay for part 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 is the difference between Part Time Cigna Utilization Review Nurse vs Part Time Cigna Case Manager?

AspectPart Time Cigna Utilization Review NursePart Time Cigna Case Manager
CredentialsRN license, certification in case management or utilization review often preferredRN or licensed healthcare professional, case management certification beneficial
Work EnvironmentReviewing medical records, assessing insurance claims, working remotely or in officeCoordinating patient care, communicating with providers and members, often remote or office-based
Employer & Industry UsageInsurance companies, healthcare organizations, primarily in health insurance industryHealth insurance providers, healthcare organizations, focusing on patient care coordination

While both roles require healthcare credentials and involve working within the insurance industry, the Part Time Cigna Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance claims, whereas the Part Time Cigna Case Manager emphasizes coordinating patient care and services. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.

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Part Time Cigna Utilization Review Nurse jobs near you

Case Manager - Utilization Review RN

Community First Medical Center

Chicago, IL • On-site

$43.47 - $53/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Community First Medical Center rating

3.9

Company rating: 3.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

1,042nd of 1,055 rated hospitals

Job description

Description:

Under the general direction of the Director of Behavioral Health, the Case Manager – Utilization Review RN provides clinically based case management and utilization review services to support the delivery of high-quality, cost-effective patient care. The RN is responsible for concurrent utilization review, medical necessity determination, denial prevention, discharge planning, care coordination, and resource management across the continuum of care.

The Case Manager – Utilization Review RN collaborates with physicians, interdisciplinary team members, physician advisors, social workers, revenue cycle staff, and third-party payers to ensure appropriate utilization of hospital resources, regulatory compliance, optimal reimbursement, and safe patient transitions.


Community First Medical Center offers benefits to all its full-time and part-time employees:

  • United Healthcare Medical PPO/HMO/HSA Plans, premiums as low as $50.00/full time, $85.00/Part Time
  • Met Life Dental and Vision
  • Paid Time Off (PTO) with annual accruals up to 168 hrs./year
  • Six paid holidays
  • Company Paid Life insurance and Short-term Disability
  • 401(k) after 90 days
  • Continuing Education reimbursement and 2 days paid off separate from PTO
  • Free Parking Garage
  • Internal Growth Opportunities


Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

QUALIFICATIONS

Education

  • Associate Degree in Nursing required.
  • Bachelor of Science in Nursing (BSN) preferred.

Experience

  • Minimum three (3) years of acute care nursing experience required.
  • Minimum two (2) years of Case Management and/or Utilization Review experience preferred.
  • Experience with discharge planning, utilization review, denial management, and payer authorization preferred.

Licensure

  • Current Illinois Registered Nurse license required.
  • ACM, CCM, or CMAC certification preferred.

KNOWLEDGE, SKILLS & ABILITIES

  • Knowledge of Medicare, Medicaid, and commercial insurance regulations.
  • Working knowledge of InterQual and/or MCG criteria.
  • Behavioral Health background knowledge
  • Access to Behavioral Health Networks
  • Understanding of utilization management and care coordination principles.
  • Knowledge of discharge planning and post-acute care resources.
  • Strong analytical and critical thinking skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple complex patient cases.
  • Ability to build collaborative relationships with physicians and interdisciplinary teams.
  • Computer proficiency and electronic medical record experience.

PERFORMANCE EXPECTATIONS

Success in this role is measured by:

  • Appropriate admission status determination
  • Denial prevention and appeal success
  • Timely discharge planning
  • Reduction in avoidable days
  • Average Length of Stay management
  • Readmission reduction
  • Documentation compliance
  • Regulatory compliance
  • Patient throughput
  • Patient and physician satisfaction

What Community First Medical Center employees say

Pay

Hours and flexibility

Workplace

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