The representative is responsible for manually reviewing and processing medical, supplemental, or dental claims according to internal policies and eligibility. Key tasks include validating medical codes, assessing benefit plans, and meeting productivity and quality metrics.
Cigna Healthcare
74 Remote Job Openings at Cigna Healthcare
Provider Relations Senior Analyst, Americas β Cigna International Health - Remote
Cigna Healthcare
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Full Time
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2 days ago
Cigna Healthcare
Manage end-to-end relationships with healthcare providers in Latin America and the Caribbean, overseeing onboarding, daily operations, and performance monitoring. Drive continuous service improvement by analyzing root causes of complaints and implementing data-driven initiatives to enhance customer experience.
The Account Manager executes operational performance strategies for specialty pharmacy clients to drive persistency, membership growth, and earnings. They manage client relationships, lead cross-functional alignment, and optimize processes to meet client needs and organizational efficiency.
Associate Senior Counsel, Real Estate (Global Real Estate)
Cigna Healthcare
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Full Time
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2 days ago
Cigna Healthcare
Serve as the primary legal advisor for the Global Real Estate organization, managing corporate leasing and the real estate portfolio. Responsibilities include drafting and negotiating leases, purchase agreements, and managing landlord-tenant disputes.
The Lead Analyst manages the client data delivery process to ensure accuracy, timeliness, and adherence to quality standards. Key duties include building Databricks dashboards, deploying code in Snowflake, and collaborating with clients to troubleshoot data sharing.
Data Licensing Sales Lead, Intelligence Solutions - Evernorth Health Services - Remote
Cigna Healthcare
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Full Time
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2 days ago
Cigna Healthcare
Drive revenue growth by licensing tokenized, privacy-preserving healthcare data assets to life sciences and analytics organizations. Lead the entire deal lifecycle from market development and commercial structuring to final contract execution.
Enterprise CX Business Project Senior Advisor
Cigna Healthcare
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Full Time
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3 days ago
Cigna Healthcare
Develop and own the end-to-end customer experience narrative for Executive Leadership Team and Board updates. Translate complex data and enterprise inputs into actionable insights and strategic recommendations to guide executive decision-making.
Pharmacy Operations Lead Representative - CarepathRx - US Remote
Cigna Healthcare
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Full Time
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3 days ago
Cigna Healthcare
Acts as the first point of contact for clients regarding PowerGridRx issues and oversees continuity of care and service. Responsibilities include triaging technical problems, managing TSS staffing, and optimizing pharmacy workflow to decrease turnaround time.
Pharmacy Technician Senior Representative - CarepathRx - US Remote
Cigna Healthcare
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Full Time
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4 days ago
Cigna Healthcare
The Pharmacy Technician supports the IVC, Authorization, and Enteral Feed teams by managing insurance verification and prior authorizations. They act as a liaison between patients, providers, and internal teams to ensure timely delivery of medications and nutrition services.
Remote Inpatient Telepharmacist, Third Shift - Evernorth
Cigna Healthcare
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Full Time
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4 days ago
Cigna Healthcare
Provide remote pharmacy services including order entry, verification, and clinical review across multiple hospitals. Collaborate with interdisciplinary care teams to deliver clinical recommendations and ensure safe medication management.
Client Account Support Senior Analyst, U-500 - Cigna Healthcare - Remote
Cigna Healthcare
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Full Time
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5 days ago
Cigna Healthcare
Manage the end-to-end client onboarding and implementation lifecycle for the Select Segment book of business. Coordinate with cross-functional teams, clients, and brokers to ensure accurate system setup for benefits, eligibility, and billing.
Define and lead the enterprise-level digital product strategy and roadmap across a complex healthcare portfolio. Drive the execution of integrated, cross-channel digital experiences while aligning senior stakeholders and leading high-performing product teams.
Sr. Data Scientist - Clinical Analytics - Remote
Cigna Healthcare
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Full Time
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5 days ago
Cigna Healthcare
Lead complex analytic initiatives to evaluate clinical programs and demonstrate value in cost, quality, and outcomes. Translate large-scale healthcare data into actionable insights and recommendations for business and clinical leaders.
SrΒ Pharmacy Account Executive β Cigna Pharmacy Management - Encore
Cigna Healthcare
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Full Time
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6 days ago
Cigna Healthcare
Manage and grow a book of business by serving as a pharmacy benefits expert for clients, brokers, and consultants. Partner with medical sales teams to deliver strategic solutions that improve health outcomes and lower the total cost of care.
Senior Growth Consultant, Commercial - Express Scripts
Cigna Healthcare
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Full Time
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7 days ago
Cigna Healthcare
The role focuses on helping health plan partners grow their employer group pharmacy benefit business through strategic go-to-market planning. Key duties include managing the pharmacy sales bid process and maintaining strong relationships with brokers and consultants.
The Counsel will provide legal guidance and negotiate client contracts for eviCore healthcare, focusing on regulatory and contract challenges. They will collaborate with internal business leadership to ensure compliant administration of the product suite across various populations.
Lead the design and delivery of the European Compliance Programme to strengthen governance and ethics frameworks across multiple jurisdictions. Act as a strategic advisor to senior leadership, managing regulatory relationships and promoting a culture of integrity.
Customer Success Manager, Pharmacy Team - Verity 340B Solutions - Remote
Cigna Healthcare
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Full Time
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12 days ago
Cigna Healthcare
Manage a portfolio of pharmacy accounts to drive 340B program performance through data-driven insights and operational support. Serve as the primary contact for clients to ensure compliance, optimize savings, and resolve complex data anomalies.
Provider Contracting Advisor - Cigna Healthcare - Wisconsin
Cigna Healthcare
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Full Time
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13 days ago
Cigna Healthcare
Manage complex fee-for-service and value-based contracting and negotiations with large physician groups and hospital systems. Develop strategic network positions and collaborate with matrix partners to ensure operational accuracy of provider agreements.
Define and champion a product vision that leverages data and analytics to improve customer outcomes and clinical insights. Lead Agile teams to build, test, and release scalable solutions while managing product backlogs and roadmaps.
Director, Network Management - Cigna Healthcare - Remote, Idaho
Cigna Healthcare
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Full Time
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13 days ago
Cigna Healthcare
Lead the strategic direction and day-to-day management of provider contracting and network activities for a specific territory. Manage complex negotiations for fee-for-service and value-based reimbursements with hospitals and large physician groups.
Develop and scale data-driven customer engagement strategies to drive behavior change and improve health outcomes. Design multichannel customer journeys and lead A/B experimentation across various digital and offline touchpoints.
Senior Pharmacy Technician - Freedom Fertility Pharmacy - AZ, MA or IL
Cigna Healthcare
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Full Time
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14 days ago
Cigna Healthcare
Coordinate fertility plans and medications by handling inbound patient calls and accurately entering prescription and insurance data. Ensure a high-quality patient experience by resolving issues and processing claims efficiently.
Inpatient Telepharmacist - Part-Time - Remote (WA/OR Pharmacist License)
Cigna Healthcare
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Full Time
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16 days ago
Cigna Healthcare
Perform remote medication order entry and verification while providing clinical guidance and therapeutic support to healthcare providers. Ensure safe patient care by assessing dosing appropriateness and maintaining compliance with pharmacy laws and HIPAA.
Managing Director, Revenue & Business Development- Verity Solutions & CarepathRX- Evernorth
Cigna Healthcare
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Full Time
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17 days ago
Cigna Healthcare
Lead the centralized growth function to define and execute growth strategies across Verity Solutions and CarepathRx. This includes identifying strategic partnerships, expanding into new markets, and aligning product strategy with enterprise priorities.
Eligibility Manager - CuraScript - Remote
Cigna Healthcare
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Full Time
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17 days ago
Cigna Healthcare
Lead a team of analysts overseeing complex chargeback, cash application, and adjustment activities to ensure operational excellence. Manage vendor relationships and drive process improvements to enhance data quality and resolve escalated financial discrepancies.
Strategy & Analytics Lead Analyst, C&CE - Evernorth - Remote
Cigna Healthcare
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Full Time
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18 days ago
Cigna Healthcare
The Lead Analyst supports C&CE strategic priorities by developing data-driven business cases and analytical models to improve customer and associate experiences. They act as a thought partner to senior leadership, distilling complex data into actionable insights and strategic recommendations.
Financial Analysis Advisor - Express Scripts - Remote
Cigna Healthcare
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Full Time
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18 days ago
Cigna Healthcare
Oversees pharmacy contractual guarantees and pricing recommendations to meet performance targets. Manages provider contracts end-to-end and leads complex financial analyses to support corporate initiatives.
Financial Analysis Senior Analyst, Billing - Evernorth - Remote
Cigna Healthcare
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Full Time
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18 days ago
Cigna Healthcare
Manage end-to-end billing relationships for a complex book of approximately 500 accounts, ensuring collection of premiums and fees. Identify process improvements to enhance client satisfaction and reduce financial risk while resolving billing inquiries.
Physician Support Specialist - Pulmonology - Accredo - Remote (MidWest/West)
Cigna Healthcare
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Full Time
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20 days ago
Cigna Healthcare
Develop and execute territory strategies to grow business through proactive outreach and relationship building with physician offices. Serve as a subject matter expert to improve clinical outcomes and reduce administrative burdens for clients.
Senior Advisor, Wholesale Market Rebate Underwriting- Express Scripts - Remote
Cigna Healthcare
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Full Time
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21 days ago
Cigna Healthcare
The role involves partnering with supply chain and cross-functional teams to deliver prescription drug information for rebate modeling and financial guarantees. The Senior Advisor will develop rebate optimization strategies and validate complex financial models for senior leadership.
Pharmacy Clinical Consulting Senior Advisor - Cigna - Remote (Nashville, TN area)
Cigna Healthcare
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Full Time
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24 days ago
Cigna Healthcare
Serve as the primary pharmacy benefits subject matter expert to support client retention and growth for integrated pharmacy clients. Collaborate with internal sales and underwriting teams to manage pharmacy components of integrated benefits and resolve complex clinical issues.
Β Infrastructure Engineering Advisor - Mainframe z/OS Storage Administrator
Cigna Healthcare
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Full Time
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24 days ago
Cigna Healthcare
Responsible for supporting and enforcing policies and best practices within the mainframe storage environment, specifically for IBM DS8000 and TS7700 platforms. Tasks include managing storage allocation, backup/recovery activities, and performing configuration changes via ServiceNow.
Senior Counsel, Regulatory - Pharmacy Services
Cigna Healthcare
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Full Time
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24 days ago
Cigna Healthcare
Serve as the primary legal advisor on pharmacy regulatory matters, managing Board of Pharmacy complaints, inspections, and enforcement actions. Provide strategic counsel on state and federal drug laws to enable business growth and manage regulatory risk across pharmacy operations.
Medical Director β Cardiology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for cardiology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Pediatric Endocrinology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for pediatric endocrinology cases using specialized software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Gastroenterology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for gastroenterology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Spine Surgery (Orthopedic or Neurosurgery) β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for spine surgery cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Pediatric Otolaryngology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for pediatric otolaryngology cases using specialized software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Otolaryngology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for Otolaryngology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Medical Oncology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for oncology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Radiation Oncology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for radiation oncology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Pain Medicine β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for pain medicine cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Perform benefit-driven medical necessity reviews and case management activities to improve clinical outcomes for members. Provide clinical insight and consultation to internal departments and serve as a clinical educator for utilization and pharmacy operations.
Medical Director β Urology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for urology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Medical Director β Pediatric Nephrology β Evicore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for pediatric nephrology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Vice President, Dental National Accounts Strategy & Business Development (Existing Business) - Remote - Cigna
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Drive growth and retention of dental national accounts by developing sales strategies and managing relationships with consultants and internal teams. Act as the primary liaison between the National Account Executive team and the Dental Organization to optimize product pricing and network strategy.
Develop and support conversational IVR call flows to enhance personalized customer experiences across voice, text, and chat channels. Collaborate with architects and business partners to design, test, and maintain high-quality code for multimedia applications.
Genetic Counselor Clinical Reviewer - EviCore - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform clinical case reviews for molecular and genetic testing requests by comparing them against established protocols. Act as an expert advisor for physicians and laboratories regarding the appropriate use of current and emerging genetic tests.
Leads clinical quality measurement and HEDIS execution while driving the transition to digital quality measurement (dQM). Manages vendor relationships, regulatory compliance, and cross-functional stakeholders to improve market performance and quality metrics.
Medical Director β Medical Genetics & Genomics β EviCore
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Perform evidence-based medical necessity reviews for genetics and genomics cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
Perform expert medical reviews of necessity requests for post-acute care services and provide clinical opinions. Conduct case conferences with nursing and social work teams to manage discharge planning and quality of care.
Vice President, Sales- Specialty Pharmacy & Infusion Services- Evernorth
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Drive strategic sales growth by expanding market presence within hospitals and health systems to maximize long-term value. Manage high-potential opportunities and collaborate with cross-functional teams to ensure an exceptional client experience.
Design and implement major components of data architecture and models to modernize Reporting & Analytics applications. Collaborate with stakeholders and development teams to create scalable data design solutions and optimize data access layers in the data lake.
Sr. Account Executive - Allergy, Asthma, Immunology - AZ, NV, UT, N.CA - Accredo - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Drive growth for specialty therapy products including Immune Globulin and Asthma/Allergy biologics within the assigned territory. Build trusted relationships with physicians and infusion centers to increase referrals and expand access to advanced therapies.
Lead a multidisciplinary account team to provide strategic guidance and operational support to health plan clients. Serve as the senior relationship owner to ensure client satisfaction, retention, and growth while partnering with product leaders to translate client needs into actionable insights.
Senior Managing Counsel - Corporate Governance
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Provides senior legal leadership and advisory support to the Board of Directors and its committees regarding corporate governance and fiduciary duties. Manages the Office of Corporate Secretary operations, including proxy filings, shareholder engagement, and subsidiary governance.
Pharmacy Account Executive (Houston) - Cigna - Remote
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
Acts as the primary pharmacy benefits expert for clients with up to 3,000 employees in the South Texas market. Manages client persistency, supports Medical Sales teams, and provides consultative recommendations based on pharmacy utilization trends.
Regional Clinical Executive - Southeast Market
Cigna Healthcare
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Full Time
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a month ago
Cigna Healthcare
The Regional Clinical Executive leads a team of clinical executives to translate enterprise priorities into actionable market strategies that improve health outcomes and affordability. This role acts as a senior clinical advisor to clients and partners across Sales, Network, and Product teams to drive regional growth and value.
Managing Counsel, Allegiance (VP β Head of Legal & Compliance)
Cigna Healthcare
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Full Time
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2 months ago
Cigna Healthcare
Serves as the senior legal and compliance leader for the Allegiance business, providing strategic counsel to executive leadership. Oversees regulatory inquiries, complex contract negotiations, and the enhancement of the compliance program including HIPAA and URAC readiness.
Sr Account Executive - Allergy, Asthma & Immunology - Northeast/New England - Remote
Cigna Healthcare
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Full Time
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2 months ago
Cigna Healthcare
Drive prescription growth and service adoption for Allergy, Asthma, and Immunology therapies within the New England territory. Build strong relationships with healthcare providers and collaborate with internal teams to ensure seamless patient access to biologic therapies.
Data Science Senior Advisor (Pricing & Underwriting) - Remote
Cigna Healthcare
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Full Time
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2 months ago
Cigna Healthcare
Develop and maintain machine learning models to optimize pricing and underwriting within the healthcare sector. Collaborate with business stakeholders and leadership to deliver actionable insights and robust analytics that drive strategic objectives.
Sr. Director - Wholesale Markets Business Development - Evernorth Health Services
Cigna Healthcare
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Full Time
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2 months ago
Cigna Healthcare
Lead the transformational growth and strategic direction of the Wholesale Markets client portfolio, focusing on new sales, product development, and account management. Oversee the design of product offerings and manage high-performing teams to ensure client retention and profitability.
AI Product Manager Senior Advisor β Enterprise Operating Model (EOM)
Cigna Healthcare
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Full Time
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2 months ago
Cigna Healthcare
The AI Product Manager Senior Advisor is responsible for defining, governing, and scaling AI capabilities across the enterprise to align with business strategy. This role partners with cross-functional teams to triage AI demand, ensure data integrity, and institutionalize AI-enabled ways of working.
The Senior Advisor will lead the execution of real estate portfolio, space, and occupancy strategies to support business growth and operational efficiency. They will also build trusted relationships with business leaders to translate workforce needs into actionable real estate plans.
Business Analytics Senior Analyst - Express Scripts - Remote
Cigna Healthcare
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Full Time
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3 months ago
Cigna Healthcare
The analyst will promote 340B program success by performing routine and ad hoc data analysis to maximize performance. They will also manage reporting efforts and build relationships with internal and external stakeholders to resolve data inquiries.
Sr. Technical Product Owner β SAP Order to Cash & Commerce Cloud β Strategy & Management
Cigna Healthcare
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Full Time
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5 months ago
Cigna Healthcare
The Senior Technical Product Owner is responsible for driving the product roadmap for integrated e-commerce and order management capabilities while ensuring alignment with product vision and strategy. This role acts as a liaison between business stakeholders and technical teams, providing guidance and making critical product decisions.
Lead the full life cycle of AI and machine learning models, from data preparation to deployment and support. Collaborate with business partners and IT teams to create reliable, secure, and compliant technology solutions.
Home Infusion Nurse, 32 hours - Accredo - Cedar Rapids, IA
Cigna Healthcare
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Full Time
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5 months ago
Cigna Healthcare
As a Home Infusion Registered Nurse, you will provide safe and effective administration of IV infusion medications in patientsβ homes while partnering with pharmacists and care teams. You will also document assessments and serve as the primary point of contact for patient updates.
Home Infusion Nurse - Accredo - Milwaukee, WI
Cigna Healthcare
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Full Time
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5 months ago
Cigna Healthcare
The Home Infusion Nurse will provide safe administration of IV infusion medications in patients' homes and partner with care teams to ensure patient well-being. They will also document patient assessments and serve as the primary contact for care coordination.
Home Infusion Nurse, Per Diem β Accredo β Rutland, VT
Cigna Healthcare
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Full Time
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5 months ago
Cigna Healthcare
The Home Infusion Registered Nurse will provide safe administration of IV infusion medications in patients' homes and partner with care teams to ensure holistic patient well-being. They will also document patient assessments and serve as the primary contact for care coordination.
Home Infusion Nurse, 32 hours - Accredo - Bismarck, ND
Cigna Healthcare
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Full Time
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6 months ago
Cigna Healthcare
As a Home Infusion Registered Nurse, you will provide safe and effective administration of specialty medications in patients' homes. You will also partner with pharmacists and care teams to ensure holistic patient well-being and serve as the primary point of contact for patient updates and care coordination.
Agile Technical Product Owner Senior Advisorβ SAP Extended Warehouse Management (EWM/RTS)
Cigna Healthcare
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Full Time
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8 months ago
Cigna Healthcare
As the Agile TPO Advisor for SAP EWM/RTS, you will own the product vision, roadmap, and delivery strategy for warehouse and logistics operations. You will work closely with business stakeholders, SAP functional experts, and development teams to deliver scalable, integrated solutions that support strategic supply chain initiatives.
Handle inbound and outbound calls from patients regarding their medical history and fertility challenges. Ensure process efficiency by coordinating fertility plans and medications while resolving customer issues.