Utilization Review Nurse Responsible for utilization review work for emergency admissions and ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
Utilization Review Nurse Responsible for utilization review work for emergency admissions and ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
Utilization Review Nurse
Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
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Utilization Review Nurse
Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Utilization Review Nurse
Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Quick apply
Utilization Review Nurse
Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Utilization Review Nurse
Dallas, TX · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Quick apply
Utilization Review Nurse
Dallas, TX · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
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 ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Quick apply
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 ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Utilization Review Nurse
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...
Utilization Review Nurse
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...
Responsible for utilization review work for emergency admissions and continued stay reviews ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
Responsible for utilization review work for emergency admissions and continued stay reviews ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
Utilization Review Nurse
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...
Utilization Review Nurse
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...
Utilization Review Nurse
$85K - $105K/yr
Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR, 97457, as needed for business operations. Employment Type: Full-Time, Exempt About Umpqua Health At ...
Utilization Review Nurse
$85K - $105K/yr
Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR, 97457, as needed for business operations. Employment Type: Full-Time, Exempt About Umpqua Health At ...
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, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
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, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
Utilization Review Nurse
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
Utilization Review Nurse
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
Utilization Review Nurse - Remote
Franklin, TN · On-site +1
The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary ...
Utilization Review Nurse - Remote
Franklin, TN · On-site +1
The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
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, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
Quick apply
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, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
Utilization Review Nurse
Murray, UT · On-site +1
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Utilization Review Nurse
Murray, UT · On-site +1
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
CA Utilization Review Nurse I
$30.64 - $45.80/hr
Utilization Review Nurse The Utilization Review Nurse gathers demographic and clinical information ... This is a remote position. Essential Functions & Responsibilities: * Identifies the necessity of ...
CA Utilization Review Nurse I
$30.64 - $45.80/hr
Utilization Review Nurse The Utilization Review Nurse gathers demographic and clinical information ... This is a remote position. Essential Functions & Responsibilities: * Identifies the necessity of ...
The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary ...
The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary ...
Review, analyze, and identify utilization patterns and trends, problems, or inappropriate ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
Review, analyze, and identify utilization patterns and trends, problems, or inappropriate ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...
... Full time remote Candidates must be based in TX. RN working in the insurance or managed care ... Provides information regarding utilization management requirements and operational procedures to ...
... Full time remote Candidates must be based in TX. RN working in the insurance or managed care ... Provides information regarding utilization management requirements and operational procedures to ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...
Remote Cigna Utilization Review Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do remote cigna utilization review nurse jobs pay per hour?
As of Aug 15, 2026, the average hourly pay for remote 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 Remote Cigna Utilization Review Nurse vs Remote UnitedHealthcare Utilization Review Nurse?
| Aspect | Remote Cigna Utilization Review Nurse | Remote UnitedHealthcare Utilization Review Nurse |
|---|---|---|
| Certifications | RN license, possibly AHC or UR certifications | RN license, possibly AHC or UR certifications |
| Work Environment | Remote, healthcare insurance setting | Remote, healthcare insurance setting |
| Employer & Industry | Cigna, health insurance industry | UnitedHealthcare, health insurance industry |
Both roles involve reviewing medical necessity and determining coverage for insurance claims. They require similar credentials and work environments, primarily serving their respective insurance companies. The main difference lies in the employer and specific policies they follow, but the core responsibilities and qualifications are comparable.
More about Remote Cigna Utilization Review Nurse jobs
What cities are hiring for Remote Cigna Utilization Review Nurse jobs?
Cities with the most Remote Cigna Utilization Review Nurse job openings:
What are the most commonly searched types of Cigna Utilization Review Nurse jobs?
The most popular types of Cigna Utilization Review Nurse jobs are:
What states have the most Remote Cigna Utilization Review Nurse jobs?
States with the most job openings for Remote Cigna Utilization Review Nurse jobs include:
What job categories do people searching Remote Cigna Utilization Review Nurse jobs look for?
The top searched job categories for Remote Cigna Utilization Review Nurse jobs are:
- Remote Preservice Review Nurse
- Remote Optum Utilization Review
- Inpatient Review Nurse
- Retrospective Review Nurse
- Remote International Utilization Review Nurse
- Medical Claims Review Nurse
- Full Time Cigna Utilization Review Nurse
- Remote Navihealth Utilization Review
- Utilization Management Review Nurse
- Optum Utilization Review Nurse
Netsmart rating
8.3
Based on 8 frontline employees who took The Breakroom Quiz
45th of 224 rated it services
Job description
Utilization Review Nurse
Responsible for utilization review work for emergency admissions and continued stay reviews. Responsibilities include:
- Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria
- Apply evidence-based clinical guidelines and criteria to assess and ensure proper utilization of healthcare resources
- Participate in telephonic discussions with emergency department physicians relative to documentation and admission status
- Enter clinical review information into system for transmission to insurance companies for authorization
- Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources
Qualifications required:
- Current and unrestricted RN license
- At least 3 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
- At least 2 years utilization management experience in acute admission and concurrent reviews
- Intermediate level experience with InterQual and/or MCG criteria within the last two years
- Proficiency in medical record review in an electronic medical record (EMR)
- Experience in Microsoft Suite including Office and basic Excel
- Ability to thrive in a fast-paced, dynamic environment and adapt to frequent changing business needs
- Passing score(s) on job-related pre-employment assessment(s)
Preferred:
- At least 5 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
- At least 3 years utilization management experience within the hospital setting
- Bachelor's of Science in Nursing (BSN)
- Case Management Certifications such as Certified Case Manager (CCM), Accredited Case Manager (ACM), Certified Managed Care Nurse (CMCN), Case Management, Board Certified (CMGT-BC)
Expectations:
- Comfortable with remote work arrangements and virtual collaboration tools
- Physical demands include extended periods of sitting, computer use, and telephone communication
Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart's sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart's third party screening provider.
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