Telephonic Registered Nurse Clinical Reviewer

The Cigna Group

Telephonic Registered Nurse Clinical Reviewer evaluating clinical service requests from providers. Authorizing services and maintaining productivity standards in a remote setting.

Posted 7/6/2026full-timeRemote • 🇺🇸 United StatesJunior💰 $31 - $52 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical utilization management and authorization processes, with a strong focus on customer service and problem-solving skills. Holds an Associate's Degree in Nursing and a current RN license, with experience in acute care and managed care settings.

Highest-signal resume keywords

Clinical Utilization ManagementAcute Care ExperienceRN LicenseCustomer Service SkillsMS Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Protocol EvaluationReview DeterminationAuthorization of Clinical ServicesProductivity Standards MaintenanceClinical Information Review

Soft Skills

Problem SolvingTeam CollaborationCommunication Skills

Certifications & Qualifications

Associate's Degree in Nursing

Industry Keywords

Managed CareER ExperienceICU ExperienceCustomer ServiceClinical Services

About the role

Key responsibilities & impact

Evaluating requests for authorization of clinical services from physician offices and/or imaging centers
Comparing requests against established clinical protocols and authorizing services or referring requests for expert clinical review
Reviewing clinical information submitted by providers and making decisions to issue a review determination
Maintaining current departmental standards related to productivity
Providing outstanding customer service ensuring callers receive the highest possible service
Assisting team members with questions and participating in team meetings

Requirements

What you’ll need

Associates Degree in Nursing required
Current, unrestricted license as an RN in state of primary residence
Must have at least 1 year of acute care, managed care, ER, ICU experience or 2 years of clinical utilization management experience
Excellent problem solving and customer service skills
Ability to hear and speak on the phone for an entire shift
Proficiency in MS Office applications

Benefits

Comp & perks

medical, vision, dental, and well-being and behavioral health programs
401(k)
company paid life insurance
tuition reimbursement
a minimum of 18 days of paid time off per year
paid holidays
leaves of absence