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Cigna Utilization Review Remote Jobs in Rochester, NY

District Manager

Rochester, NY · On-site +1

$87K - $126.23K/yr

Ensure compliance, effectiveness and full utilization of co-op marketing funds. * Assist in the ... Implement and execute dealer specific return to market plans General Administration - 10% * Review ...

District Manager

Rochester, NY · Remote

$87K - $126.23K/yr

Ensure compliance, effectiveness and full utilization of co-op marketing funds. * Assist in the ... Implement and execute dealer specific return to market plans General Administration - 10% * Review ...

The position is remote, but you must be located in or near Rochester, NY due to the frequency with ... How You Qualify You reviewed the Who You Are section of this job posting and immediately felt the ...

Cigna Utilization Review Remote information

See Rochester, NY salary details

$15

$31

$52

How much do cigna utilization review remote jobs pay per hour?

As of May 29, 2026, the average hourly pay for cigna utilization review remote in Rochester, NY is $31.51, according to ZipRecruiter salary data. Most workers in this role earn between $22.07 and $40.10 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Cigna Utilization Review Remote Nurse, and why are they important?

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 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 position?

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 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 the most commonly searched types of Cigna Utilization Review jobs in Rochester, NY? The most popular types of Cigna Utilization Review jobs in Rochester, NY are:
What are popular job titles related to Cigna Utilization Review Remote jobs in Rochester, NY? For Cigna Utilization Review Remote jobs in Rochester, NY, the most frequently searched job titles are:
What cities near Rochester, NY are hiring for Cigna Utilization Review Remote jobs? Cities near Rochester, NY with the most Cigna Utilization Review Remote job openings:
Infographic showing various Cigna Utilization Review Remote job openings in Rochester, NY as of May 2026, with employment types broken down into 1% As Needed, 57% Full Time, 37% Part Time, 2% Temporary, and 3% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution, with an average salary of $65,550 per year, or $31.5 per hour.
Clinical Sales Manager (Western NY & PA)

Clinical Sales Manager (Western NY & PA)

Karius

Rochester, NY • On-site, Remote

Full-time

Medical, Vision, Life

Posted 15 days ago


Job description

About Karius
Karius is a venture-backed life science startup focused on transforming the way infectious diseases are diagnosed. Combining Next-Generation Sequencing and proprietary data analysis, we can identify over 1,000 pathogens from a single blood sample with typical turnaround time in one business day. By unlocking the information present in microbial cell-free DNA, we're helping doctors quickly solve their most challenging cases, with a future vision of accelerating clinical trials, discovering new microbes, and reducing patient suffering worldwide.
Position Summary
This represents an incredible opportunity to join a growing life sciences company poised to revolutionize the Infectious Disease diagnostics market. We are expanding the launch of our proprietary, Next-Generation Sequencing test in hospitals and health systems across the U.S. Joining Karius in our commercialization effort will both accelerate your career and advance our vision to see a world where infectious disease is no longer a major threat to human health. The Clinical Sales Manager is responsible for the sales efforts of Karius in a defined regional territory, focusing on relationships with infectious disease physicians, lab directors, C-level executives, and other clinical leaders throughout a hospital system.
Why Should You Join Us?
Karius aims to conquer infectious diseases through innovations around genomic sequencing and machine learning. The company's platform is already delivering unprecedented insights into the microbial landscape, providing clinicians with a comprehensive test capable of identifying more than a thousand pathogens directly from blood, and helping industry accelerate the development of therapeutic solutions. The Karius test we provide today is one of the most advanced solutions available to physicians who aim to deliver better care to many otherwise ineffectively treated patients. Our test is the result of some incredible work done by our scientists, statisticians, engineers, and physicians, all driven by the same mission. You, as part of the Karius team, will be able to see how directly your work has a life-changing impact on people, and at scale.
Reports to: Regional Sales Director
Territory: Western New York and Western Pennsylvania with deep knowledge and experience in the greater metropolitan area health systems.
Primary Responsibilities
• Grow sales revenue and test volume in territory by establishing new business in hospitals while increasing volume in existing hospitals. Introduce a transformational, life-saving diagnostic technology which will change the world of infectious disease by engaging key stakeholders in the hospital that are involved with the decision process to implement new diagnostic tests.
• Collaboration with Inside Sales, Customer Success, Medical Affairs, and Marketing to achieve territory and company goals.
• Develop thought leaders and early adopters for this new approach to infectious disease diagnosis.
• Help establish the foundation and culture of a world-class commercial organization.
• Build, manage and nurture market-based/regional territory, comprising hospital & health system accounts.
• Prioritize and segment hospital & health system accounts to maximize opportunity and growth.
• Present product features and benefits to key stakeholders and clinical call points, utilizing consultative sales techniques (qualifying leads, assessing needs, supporting evaluations, and closing). Manage early evaluations to activate initial adoption of Karius test/solutions and drive increased utilization over time.
• Serve as a subject matter expert, speaking with clinicians of all levels regarding the science and technology of the Karius test and how to best leverage its capabilities. Speak fluently on the unique merits and value of our proprietary test, positioning our differentiation from the competition.
• Build deep relationships, educate and drive consensus across multiple stakeholders among both prospective and existing partners.
• Develop a 'trusted advisor' relationship and establish oneself as fully accountable for demonstrating ROI to the partner account, ensuring both regular interaction and utilization review.
• Secure contracts and agreements, where necessary or optimal, to memorialize long-term relationships with partners, define an exchange of value, and augment predictability into revenue.
• Manage and secure renewals of partner agreements.
• Collaborate with Sales, Marketing, and Product leadership to provide valuable market feedback, to inform all functions.
• Partner, and co-present, with Karius' Clinical/Medical Affairs teams (including Medical Science Liaisons) to support partner interactions, both remote and in-person, and manage follow-up.
• Collaborate with Customer Success to onboard new accounts, share feedback, proactively address risks, immediately address concerns/problems, manage expectations, promote successes, and maintain close pulse on the health of the partner.
• Partner with Marketing to identify and co-manage regional meeting opportunities, develop Key Opinion Leader (KOL) panels, and other local market activities.
• Participate in broader sales meetings, training programs, conventions, and industry trade shows as required.
• Complete paperwork and administrative duties in a timely and accurate fashion, including documentation in SalesForce, expense reporting, speaker program information, etc.
What's Fun About the Job?
Karius is operating at the edge of what is now known to be possible in infectious disease diagnostics. With that, comes a wave of new and incredible challenges and opportunities. To deliver on that value, you will be tapping into some of the most advanced technologies, architecting and innovating where the current solutions simply don't suffice. You will get to see how much your work really matters.
Travel: Up to 70%.
Physical Requirements
Subject to extended periods of sitting and/or standing, vision to monitor and moderate noise levels. Work is generally performed remotely in the field.
Position Requirements
• Bachelor's degree; advanced degree or MBA a plus.
• 5 years of sales/business development experience in Life Sciences / Biotech, Medical Device, Diagnostic Equipment, and/or Pharmaceutical industries.
Valid driver's license.
• Previous success in introducing transformational, novel products or services to physicians and hospitals which have changed clinical practice prior to significant peer-reviewed publications or inclusion in guidelines for support.
• Robust network of existing relationships in hospitals and health systems, across microbiology labs, send-out labs, physician groups, C-level executives, and administrators of clinical functions.
• Strong vision and planning capabilities to grow the territory.
• Excellent business acumen combined with outstanding analytical aptitude and problem-solving skills.
• Strong ability to develop relationships from C-level executives to physicians and lab directors, building credibility through subject matter and industry expertise.
• Demonstrated track record of top sales achievement, meeting and exceeding sales objectives.
• Experience with multi-level account management.
Personal Qualifications
• Entrepreneurial spirit and is comfortable multitasking and working in a fast-paced, ambiguous, growth-oriented environment.
• Team player willing to collaborate with all customer facing teams to share best practices.
• Ability to set priorities, allocate resources, take accountability and achieve results.
• Strong presentation acumen and negotiation skills, ability to manage and facilitate engaging discussions with both small and large groups.
• Unquestionable personal code of ethics, integrity, confidentiality and ability to build trusting and professional relationships.
• Passionate about the mission and reputation of Karius while investing in the culture as the company grows.
Disclaimer
The above job description is intended to describe the general nature and level of work being performed by individuals assigned to this position. It is not intended to be an exhaustive list of all duties, responsibilities, and skills required. Responsibilities and duties may change or be adjusted to meet the needs of the company, and additional duties may be assigned as necessary. The job description is subject to change at any time at the discretion of Karius.
Equal Opportunity Employer
At Karius, we value a diverse and inclusive workplace and provide equal employment opportunities for all applicants and employees and are committed to honor and invest in the full diversity of people, in our hiring, recruiting and development of employees across the Company. All qualified applicants for employment are encouraged to apply and will be considered without regard to an individual's race, color, sex, gender identity and gender expression (including transgender individuals who are transitioning, have transitioned, or are perceived to be transitioning to the gender with which they identify), religion, age, national origin or ancestry, citizenship, physical or mental disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military or veteran status, or any other basis protected by federal, state or local laws. If you are unable to submit your application due to a disability, please contact us at [email protected] and we will accommodate qualified individuals with disabilities.
$118,337 - $177,505 a year