Remote Utilization Management RN – Clinical Reviewer

Cigna Health and Life Insurance Company; Northern (KY); Hybrid; USD 43,000 - 72,000; Full time

Benefits offered by this job

Health benefits

401(k)

Tuition reimbursement

Paid time off

Job summary

Cigna Health and Life Insurance Company is seeking a remote Utilization Management Clinical Reviewer licensed as an RN in California. The role supports inpatient care coordination, evaluates medical necessity, and guides members through transitions across the care continuum.

Required CA RN licensure and 2+ years of direct RN experience, with strong communication and the ability to work independently from home. Competitive hourly pay and eligibility for annual bonus are included.

Qualifications

• Active California RN license.
• At least 2 years of direct clinical RN experience in inpatient or managed care.
• Strong communication, organization and independent work in a remote environment.

Responsibilities

• Manage an assigned caseload of complex inpatient cases and coordinate care transitions.
• Perform prospective, concurrent and retrospective clinical reviews for inpatient care and related services.
• Apply clinical guidelines to evaluate medical necessity and discharge needs and document decisions.

Skills

RN licensure (CA)

2+ years RN experience

Education

Bachelor's in Nursing (preferred)

Tools

EMR systems

Job description

Cigna Health and Life Insurance Company is seeking a remote Utilization Management Clinical Reviewer licensed as an RN in California. The role supports inpatient care coordination, evaluates medical necessity, and guides members through transitions across the care continuum.

Required CA RN licensure and 2+ years of direct RN experience, with strong communication and the ability to work independently from home. Competitive hourly pay and eligibility for annual bonus are included.