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Seasonal Cigna Rn Remote Jobs in Baltimore, MD (NOW HIRING)

Cinqcare

Registered Nurse

Laurel, MD · Remote

Deploys Remote Patient Monitoring and Patient Self Reporting for High-Risk Chronic Conditions ... The RN will establish the business strategy and roadmap: (1) improve outcomes for Grace at Home ...

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All JobsCigna Rn JobsSeasonal Cigna Rn Remote JobsSeasonal Cigna Rn Remote Jobs in Baltimore, MD

Seasonal Cigna Rn Remote information

What is the difference between Seasonal Cigna Rn Remote vs Cigna Rn?

AspectSeasonal Cigna Rn RemoteCigna Rn
CertificationsRN license, possibly additional certifications depending on roleRN license, possibly additional certifications depending on role
Work EnvironmentRemote, seasonal assignmentsTypically remote or onsite, full-time or part-time
Employer & IndustryCigna, health insurance industryCigna, health insurance industry
Work DurationSeasonal, temporaryOngoing, full-time or part-time

Seasonal Cigna Rn Remote roles are temporary, seasonal positions primarily remote, while Cigna Rn roles are ongoing positions that may be full-time or part-time. Both require RN licensure and work within the health insurance industry, but the seasonal roles are designed for short-term coverage, whereas regular Cigna Rn positions offer continuous employment opportunities.

What are popular job titles related to Seasonal Cigna Rn Remote jobs in Baltimore, MD? For Seasonal Cigna Rn Remote jobs in Baltimore, MD, the most frequently searched job titles are:
What job categories do people searching Seasonal Cigna Rn Remote jobs in Baltimore, MD look for? The top searched job categories for Seasonal Cigna Rn Remote jobs in Baltimore, MD are:
Seasonal Cigna Rn Remote jobs near you
Infographic showing various Seasonal Cigna Rn Remote job openings in Baltimore, MD as of July 2026, with employment types broken down into 65% Full Time, 25% Part Time, and 10% Contract. Highlights an 90% In-person, 5% Hybrid, and 5% Remote job distribution.

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 10 days ago

Job description

Utilization Management Specialist (UM / Utilization Review Nurse) — Remote

Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: Mon–Fri, 8:00am–5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00am–9:00am ET Pay (W2): USD 51.00/H

Job overview

In this role, you’ll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. You’ll work fully remote and leverage MCG, medical policy, and regulatory guidelines while collaborating with Medical Directors and internal teams to support timely, accurate authorization decisions.

What you’ll do

  • Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health).
  • Make medical necessity / appropriateness determinations and support prior authorizations.
  • Use clinical criteria and policy resources daily (including MCG / Milliman Care Guidelines).
  • Review clinical documentation, benefits, and mandates to ensure services align with coverage and guidelines.
  • Research diagnoses/treatments and high-cost services; summarize findings and escalate complex cases to Medical Directors as needed.
  • Collaborate with internal partners and providers to support benefit application and appropriate levels/settings of care.
  • Maintain accurate documentation and protect PHI while managing a busy caseload.

Required qualifications

  • Active RN or LPN license (RN preferred) — Maryland compact/eligibility required
  • 5+ years clinical nursing experience
  • 2+ years care management / utilization management experience
  • MCG experience (required)
  • Experience supporting Commercial/FEP/Medicare lines of business and applying medical policy/regulatory standards
  • Strong critical thinking, written communication, and ability to work independently in a remote setting
  • Comfortable with web-based tools + Microsoft Office (Word/Excel/PowerPoint)
  • Guiding Care and FACETS (required)

Nice to have

  • Critical Care or ER clinical background
  • Experience with LCD/NCD, Medicare guidelines, ASAM, or other authorization criteria sets

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-1 #LI-AJ1 Ref: #851-Rockville-S1