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Cigna Utilization Review Remote Jobs in Arizona (NOW HIRING)

TM

Phoenix, AZ · Remote

Conduct quarterly business reviews with key accounts to assess performance and identify growth ... Remote monitoring workflow development, Utilization ramp and adoption metrics * Strong executive ...

Distribution Field Manager - West

Phoenix, AZ · Remote

$86K - $173K/yr

  • Medical

  • Retirement

... utilization in current accounts. Understands and assesses customer's business issues and objectives ... This is a remote sales opportunity and will cover the West Region (AZ/NV/CA/ID/OR/WA) estimated 70 ...

Distribution Field Manager - West

Phoenix, AZ · Remote

$86K - $173K/yr

  • Medical

  • Retirement

... utilization in current accounts. Understands and assesses customer's business issues and objectives ... This is a remote sales opportunity and will cover the West Region (AZ/NV/CA/ID/OR/WA) estimated 70 ...

Showing results 41-60

Cigna Utilization Review Remote information

What are the key skills and qualifications needed to thrive as a Cigna Utilization Review Remote nurse?

To thrive as a Cigna Utilization Review Remote Nurse, you need a valid RN license, clinical experience (often in case management or utilization review), and a strong understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic medical records (EMRs), and knowledge of Medicare/Medicaid policies or URAC/NCQA standards is typically required. Excellent critical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and coordinating with providers. These skills ensure accurate, compliant decisions that support patient care while managing healthcare costs efficiently in a remote environment.

What is the difference between Cigna Utilization Review Remote vs Cigna Medical Reviewer?

AspectCigna Utilization Review RemoteCigna Medical Reviewer
CredentialsRN or licensed healthcare professionalRN or licensed physician
Work EnvironmentRemote, telehealth settingRemote or onsite, clinical setting
Employer & IndustryCigna, health insurance industryCigna, healthcare and insurance industry
Primary FocusReview of insurance utilization for appropriatenessClinical assessment and direct patient care

While both roles involve healthcare review, Cigna Utilization Review Remote focuses on evaluating insurance claims remotely, whereas Cigna Medical Reviewer provides direct clinical assessments, often with more patient interaction. Both require healthcare credentials and are integral to Cigna's healthcare services, but their daily tasks and focus differ.

What are some common challenges faced by Cigna Utilization Review professionals working remotely, and how can these be effectively managed?

Cigna Utilization Review professionals working remotely often encounter challenges such as maintaining clear communication with healthcare providers and team members, managing high caseload volumes, and staying updated on evolving clinical guidelines. To address these challenges, it’s important to leverage Cigna’s robust digital collaboration tools, participate actively in virtual team meetings, and utilize ongoing training resources. Setting a structured daily routine and prioritizing tasks can also help ensure timely and accurate reviews, while maintaining work-life balance in a remote setting.

What is a Cigna Utilization Review Remote?

A Cigna Utilization Review Remote position involves evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to Cigna members—all while working from a remote location. Utilization Review professionals, often nurses or clinicians, review clinical information, make coverage determinations, and coordinate with providers to ensure members receive the right care. This role combines clinical expertise with knowledge of insurance guidelines and regulatory requirements, allowing for flexible work arrangements from home. It plays a critical role in managing healthcare costs and improving patient outcomes.

What cities in Arizona are hiring for Cigna Utilization Review Remote jobs?

Cities in Arizona with the most Cigna Utilization Review Remote job openings:

Clinical Account Representative, CardioMEMS - Phoenix/Scottsdale, AZ

Abbott

Chandler, AZ • Remote

Full-time

Medical, Retirement, PTO

Re-posted 21 days ago


Abbott rating

7.8

Company rating: 7.8 out of 10

Based on 138 frontline employees who took The Breakroom Quiz

178th of 539 rated manufacturers


Job description

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries.JOB DESCRIPTION:

Working at Abbott

At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You'll also have access to:

  • Career development with an international company where you can grow the career you dream of.

  • Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year

  • An excellent retirement savings plan with high employer contribution

  • Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree.

  • A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune.

  • A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists.

Heart Failure

In Abbott's Heart Failure (HF) business, we're developing solutions to diagnose, monitor and manage heart failure, allowing people to restore their health and get on with their lives.

The Clinical Account Representative (CAR) supports the growth of CardioMEMS by driving utilization, supporting key accounts, and delivering education and technical support. This is a sales-forward role focused on account development, workflow optimization, and expanding access to the therapy. The CAR operates at the intersection of clinical expertise, relationship management, and commercial execution, ensuring that CardioMEMS is successfully integrated into heart failure care pathways and delivers measurable patient and economic value.

WHAT YOU'LL DO

1. Sales & Customer Engagement

  • Serve as the primary point of contact for highvolume, established accounts, ensuring seamless onboarding and patient monitoring workflows.

  • Achieve assigned sales and utilization targets within defined accounts.

  • Execute actionable quarterly business plans with clear activity goals and growth drivers.

  • Conduct routine account checkins to review program performance, identify barriers, and uncover new opportunities.

  • Deliver product demonstrations and participate in educational meetings to drive adoption and expand utilization.

  • Provide competitive insights, including customer feedback and market intelligence.

  • Provide coverage for Territory Managers during PTO, meetings, and peak demand periods.

2. Account Management

  • Maintain CRM documentation for key accounts, including activity notes, opportunities, and followups.

  • Build and sustain strong relationships with physicians, APPs, HF clinics, and administrators.

  • Conduct quarterly account reviews in collaboration with Territory Manager to support program health, patient volume trends, and operational needs.

  • Support the execution of workflow optimizations to improve patient identification, onboarding, and monitoring processes.

3. Technical & Clinical Support

  • Provide technical troubleshooting for remote monitoring issues and workflow challenges, escalating as needed.

  • Offer procedural case support occasionally for broader territory, focusing on priority accounts.

  • Support training and education for new clinical staff, HF clinics, and administrators.

  • Participate in product inservices and support clinical data collection as needed.

  • Continue developing strong product, HF, and CardioMEMS competency.

4. Compliance & Collaboration

  • Adhere to all FDA, regulatory, and company quality requirements.

  • Maintain accurate documentation of sales activities, account plans, expenses, and clinical interactions.

  • Collaborate effectively with Territory Managers, Marketing, Professional Education, Clinical Specialists, and sales leadership.

  • Maintain professional, compliant, and positive communication with all hospital and internal stakeholders.

EDUCATION AND EXPERIENCE YOU'LL BRING

Required

  • Bachelor's degree (Business, Life Sciences, Engineering, or related).

  • Experience: 2-4 years in medical device or healthcare (inside or field).

  • Demonstrates consultative selling skills, including uncovering needs, asking strategic questions, and positioning solutions that drive utilization growth.

  • Track record of 100% to goal in the most recent performance year.

  • Account-facing experience with clinicians and administrators (e.g., HF clinics, service line leaders).

  • Proficiency with CRM (Salesforce preferred), Excel/analytics, and PowerPoint.

  • Comfortable delivering clinical/technical presentations to audiences of 10-50 stakeholders.

Preferred

  • Knowledge of reimbursement landscape and payment pathways (highly preferred).

  • Experience at top MedTech organizations (highly preferred).

  • 1-2 years of commercial experience.

  • Experience in Cardiology/HF/EP/Structural Heart or remote monitoring.

  • Prior involvement in value analysis or committeebased selling.

  • Familiarity with Cath lab/OR workflows; basic procedural support experience.

Apply Now

Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: www.abbottbenefits.com

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott, and on Twitter @AbbottNews.

The base pay for this position is

$68,000.00 - $136,000.00

In specific locations, the pay range may vary from the range posted.

JOB FAMILY:Support ServicesDIVISION:HF Heart FailureLOCATION:United States of America : RemoteADDITIONAL LOCATIONS:WORK SHIFT:StandardTRAVEL:Yes, 25 % of the TimeMEDICAL SURVEILLANCE:Not ApplicableSIGNIFICANT WORK ACTIVITIES:Continuous standing for prolonged periods (more than 2 consecutive hours in an 8 hour day), Continuous walking for prolonged periods (more than 2 hours at a time in an 8 hour day), Driving a personal auto or company car or truck, or a powered piece of material handling equipmentAbbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdfEEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf

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