RN Case Manager The RN Case Manager is responsible for the delivery of comprehensive nursing care ... Participates in utilization review and/or continuous quality improvement activities as requested.
RN Case Manager The RN Case Manager is responsible for the delivery of comprehensive nursing care ... Participates in utilization review and/or continuous quality improvement activities as requested.
RN Case Manager The RN Case Manager is responsible for the delivery of comprehensive nursing care ... Participates in utilization review and/or continuous quality improvement activities as requested.
RN Case Manager The RN Case Manager is responsible for the delivery of comprehensive nursing care ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
Registered Nurse (RN) Case Manager, Palliative Home Care (Full-Time, Days)
Rochester, NY · On-site
$77K - $103K/yr
Participates in utilization review and/or continuous quality improvement activities as requested ... Registered Nurse license in New York State PREFERRED QUALIFICATIONS * 1 year of nursing experience
Registered Nurse (RN) Case Manager, Palliative Home Care (Full-Time, Days)
Rochester, NY · On-site
$77K - $103K/yr
Participates in utilization review and/or continuous quality improvement activities as requested ... Registered Nurse license in New York State PREFERRED QUALIFICATIONS * 1 year of nursing experience
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those ... Participates in utilization review and/or continuous quality improvement activities as requested.
Looking for nurses with 2 years RN exp in acute care with some utilization mgt, prior authorization, concurrent review, great with Excel and someone who can Multitask (e.g. on the phone while using ...
Looking for nurses with 2 years RN exp in acute care with some utilization mgt, prior authorization, concurrent review, great with Excel and someone who can Multitask (e.g. on the phone while using ...
Assures prudent utilization of all resources (fiscal, staff resources, environmental, equipment and ... Reviews all assigned Outpatient Observation patients and verifies correct status assignment and ...
Assures prudent utilization of all resources (fiscal, staff resources, environmental, equipment and ... Reviews all assigned Outpatient Observation patients and verifies correct status assignment and ...
Utilization Management Services Rep I
$15.75 - $21.50/hr
... nursing facilities, mid-level providers, members, pharmacies, pharmacists, and support staff ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.
Utilization Management Services Rep I
$15.75 - $21.50/hr
... nursing facilities, mid-level providers, members, pharmacies, pharmacists, and support staff ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.
Utilization Management Services Rep I
Rochester, NY · On-site
$15.75 - $21.50/hr
... nursing facilities, mid-level providers, members, pharmacies, pharmacists, and support staff ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.
Utilization Management Services Rep I
Rochester, NY · On-site
$15.75 - $21.50/hr
... nursing facilities, mid-level providers, members, pharmacies, pharmacists, and support staff ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
Quick apply
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
CLINICAL AUDIT SPECIALIST
Rochester, NY · On-site
$65K - $70K/yr
Master's Degree in Social Work, Mental Health Counseling, Psychology, Nursing or related field ... Preferred experience in quality assurance, utilization review or clinical auditing. Experience with ...
Quality Review Team Manager-Home Care Department: Home Care Operations Location: 330 Monroe Avenue ... utilization guidelines and practice standards are followed by nurses in the delivery of nursing ...
Quality Review Team Manager-Home Care Department: Home Care Operations Location: 330 Monroe Avenue ... utilization guidelines and practice standards are followed by nurses in the delivery of nursing ...
Registered Nurse - Ambulatory Procedure Center (APC)
Canandaigua, NY · On-site
$38 - $50/hr
... the utilization of the nursing process * Demonstrates the ability to work independently and ... For further information, please review the Know Your Rights notice from the Department of Labor.
Registered Nurse - Ambulatory Procedure Center (APC)
Canandaigua, NY · On-site
$38 - $50/hr
... the utilization of the nursing process * Demonstrates the ability to work independently and ... For further information, please review the Know Your Rights notice from the Department of Labor.
Entry Level Utilization Review Nurse information
See Rochester, NY salary details
$21.12 - $25.39
2% of jobs
$25.39 - $29.66
9% of jobs
$32.58 is the 25th percentile. Wages below this are outliers.
$29.66 - $33.93
21% of jobs
The median wage is $37.39 / hr.
$33.93 - $38.20
23% of jobs
$38.20 - $42.47
13% of jobs
$45.80 is the 75th percentile. Wages above this are outliers.
$42.47 - $46.75
10% of jobs
$46.75 - $51.02
8% of jobs
$51.02 - $55.29
5% of jobs
$55.29 - $59.56
5% of jobs
$59.56 - $63.83
2% of jobs
$63.83 - $68.10
2% of jobs
$21
$41
$68
How much do entry level utilization review nurse jobs pay per hour?
How to get into utilization review as an entry level utilization review nurse?
What are some common challenges faced by entry level utilization review nurses, and how can they overcome them?
What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?
| Aspect | Entry Level Utilization Review Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, possibly some certification | RN license, often with additional certifications |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Insurance companies, healthcare organizations |
| Job Responsibilities | Assist in reviewing patient cases, gather data, support senior staff | Evaluate medical necessity, review patient records, make coverage decisions |
The Entry Level Utilization Review Nurse typically supports the more experienced Utilization Review Nurse by gathering information and assisting in case reviews. Both roles require an RN license and work within healthcare or insurance settings, but the entry-level position involves more support tasks, while the Utilization Review Nurse makes critical coverage decisions.
What are the key skills and qualifications needed to thrive as an entry level utilization review nurse, and why are they important?
What is an entry level utilization review nurse?
- Remote Utilization Review Nurse
- Remote Medical Record Review Nurse
- Rn Government
- Freelance Utilization Review Nurse
- No Experience Utilization Management Nurse
- Medical Review Nurse
- Telephonic Nurse Case Manager
- Registered Nurse No Weekends No Holidays
- Rn Case Management No Experience
- Flex Schedule Remote Utilization Review Nurse
- Pediatric Utilization Review
- Optum Utilization Review Nurse
- Full Time Cigna Utilization Review Nurse
- Fulltime Cigna Utilization Review Nurse
- Volunteer Navihealth Utilization Review
- Remote Rn Utilization Review Nurse
- Hospital Case Manager
- Seasonal Remote Utilization Review
- Remote Utilization Review Manager
- Live In Cigna Utilization Review Nurse

Registered Nurse (RN) Case Manager I (Full-Time, Days) - Home Care
Newark, NY • On-site
Other
Re-posted 26 days ago
Rochester Regional Health rating
7.3
Based on 218 frontline employees who took The Breakroom Quiz
304th of 887 rated healthcare providers
Job description
The RN Case Manager is responsible for the delivery of comprehensive nursing care to a set of assigned patients at a specific point in time. This involves the assessment of patient and family needs and the development, implementation and evaluation of an appropriate Plan of Care, making changes in response to changing patient needs. The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those services and supervises Private Duty Nurses (PDN) as applicable.
STATUS: Full-Time
LOCATION: Rochester Regional Health Home Care - Newark
DEPARTMENT: HHC CHHA NE REGION NURSING
SCHEDULE: Monday-Friday, 8:00am-4:00pm
Why Join Our Team?
- Set your own work schedule to fit your lifestyle and work-life balance
- Mileage reimbursement + paid drive time between patient visits
- Shift differentials to reward your flexibility
- Overtime opportunities for additional earning potential
- Up to $10,000 in tuition assistance for BSN to MSN advancement
- Tuition and student loan assistance programs to support your financial goals
- Comprehensive full benefits package
ATTRIBUTES
- Level I - 1 year of nursing experience preferred.
- Prior home health, clinical and direct patient care experience preferred.
- Ability to work independently.
- Demonstration of solid interpersonal, organizational and time management skills.
- Proficient computer skills.
- Must be able to document clinical notes and assessments within an electronic medical record.
- Ability to travel to and from required locations as needed to perform the essential responsibilities of the job.
- Level II – requires similar qualifications as level I, plus:
- Understands when to escalate to management.
RESPONSIBILITIES
- Identifies and prioritizes health problems based on assessment
- Develops or implements an interdisciplinary Plan of Care based on the needs identified during the assessment, with input from the patient (and their caregivers as applicable), in collaboration with the attending physician and other care team members
- Manages and coordinates patient care, including clinically complex cases, in a manner which ensures the efficient and effective delivery of appropriate services and community supports
- Exhibits proficiency and accuracy in the completion of comprehensive assessment/documentation, which may include assessments required by payer sources (e.g., Outcome and Assessment Information Set (OASIS), Hospice Item Set (HIS)).
- Plans, organizes and prioritizes care needs for an assigned caseload of patients to ensure their care needs are met and services are delivered according to plan of care
- Communicates all changes in patient status and/or service needs to the appropriate care team member and ensures appropriate action is taken in a timely manner
- Facilitates the development and implementation of patient discharge plans as indicated
- Documents all patient care and coordinating activities per agency standards
- Assesses the need for additional services (aide, therapies, social work or a community service) and obtains orders and arranges care as indicated
- Supervises and evaluates care provided by Licensed Practical Nurses and/or home health aides in the performance of his/her patient care duties
- Works collaboratively with other care team members by communicating all changes in patient status and/or service needs to the appropriate care team member and ensures appropriate action is taken in a timely manner.
- Correctly identifies patient/family risk factors and establishes goals and interventions to reduce/remove risk from the plan of care to enable patients to remain in the least restrictive care setting.
- Coordinate/participate in interdisciplinary team meetings/patient care conferences.
- Patient needs are prioritized; visits outside primary team assignment or geographical area may be required in order to meet patient need.
- Practices according to Agency and community standards
- Participates in utilization review and/or continuous quality improvement activities as requested.
- Attends required staff meetings, in-services and/or supervisory conferences.
- Participates in on-call schedule and weekend/holiday schedule as assigned.
- Consistently demonstrates high standards of integrity by supporting the Rochester Regional Health Companies' mission and values and adhering to the Corporate Code of Conduct.
- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
- Regular and reliable attendance is expected and required.
- Performs other job-related duties as assigned by management.
REQUIRED QUALIFICATIONS
- Diploma or Associate's Degree in Nursing required
- Registered Nurse license in New York State.
- Valid NYS Driver's License.
PREFERRED QUALIFICATIONS
- Bachelor's Degree in Nursing preferred.
EDUCATION:
LICENSES / CERTIFICATIONS:
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$77,983.00 - $103,906.00
CITY:
Newark
POSTAL CODE:
14513
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.
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About Rochester Regional Health
Sourced by ZipRecruiter
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Rochester, NY, US
Year founded
2014