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Entry Level Utilization Review Nurse Jobs in Rochester, NY

Highland Hospital

RN Case Manager (Hospital)

Rochester, NY · On-site

$77K - $93K/yr

... utilization management, proactive patient management, care facilitation and treatment planning ... Complete the Patient Review Instrument * Other duties as assigned Salary Range: $77,220.15- $93,600 ...

Jewish Senior Life

RN Supervisor

Rochester, NY · On-site

$80K - $95K/yr

Determines optimal utilization of staff for the delivery of nursing services throughout the shift ... Completes performance evaluations on assigned staff as well as reviewing evaluations with ...

Rochester Regional Health

Care Manager-RN

Rochester, NY · On-site

$82K - $113K/yr

Evaluation & Review. Evaluate hospital admissions to assure care is medically necessary and ... Three (3) years of acute hospital care, case management or utilization management experience ...

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Entry Level Utilization Review Nurse information

See Rochester, NY salary details

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$41

$68

How much do entry level utilization review nurse jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for entry level utilization review nurse in Rochester, NY is $41.74, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

How to get into utilization review as an entry level utilization review nurse?

To become an entry-level utilization review nurse, candidates typically need a nursing license (RN) and relevant clinical experience. Gaining knowledge of insurance policies, medical coding, and utilization review processes through training or certification programs such as the Certified Professional in Healthcare Quality (CPHQ) can improve job prospects.

What are some common challenges faced by entry level utilization review nurses, and how can they overcome them?

Entry level Utilization Review Nurses often encounter challenges such as adapting to complex insurance policies, learning to review medical records efficiently, and communicating effectively with physicians and case managers. To overcome these challenges, new nurses should seek mentorship from experienced colleagues, participate in ongoing training sessions, and familiarize themselves with the organization's review protocols and documentation systems. Building strong communication skills and staying up to date with regulatory changes will also help in navigating the learning curve and ensuring successful case reviews.

What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?

AspectEntry Level Utilization Review NurseUtilization Review Nurse
CredentialsRN license, possibly some certificationRN license, often with additional certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, healthcare organizations
Job ResponsibilitiesAssist in reviewing patient cases, gather data, support senior staffEvaluate 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?

To thrive as an Entry Level Utilization Review Nurse, you need a registered nurse (RN) license, knowledge of clinical guidelines, and an understanding of healthcare regulations. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are often beneficial. Strong analytical thinking, attention to detail, and effective communication skills help you review cases accurately and collaborate with providers. These skills ensure appropriate care decisions, compliance with payer requirements, and optimal patient outcomes.

What is an entry level utilization review nurse?

An Entry Level Utilization Review Nurse is a registered nurse (RN) who is new to the field of utilization review. Their main responsibilities include assessing medical records, ensuring that patients receive appropriate and necessary care, and verifying that health services are delivered according to established guidelines and insurance requirements. They typically work for hospitals, insurance companies, or managed care organizations and collaborate with healthcare providers to support quality patient outcomes while managing costs. This role often serves as a stepping stone to more advanced positions in healthcare administration or case management.
What are the most commonly searched types of Utilization Review Nurse jobs in Rochester, NY? The most popular types of Utilization Review Nurse jobs in Rochester, NY are:
What are popular job titles related to Entry Level Utilization Review Nurse jobs in Rochester, NY? For Entry Level Utilization Review Nurse jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Entry Level Utilization Review Nurse jobs in Rochester, NY look for? The top searched job categories for Entry Level Utilization Review Nurse jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Entry Level Utilization Review Nurse jobs? Cities near Rochester, NY with the most Entry Level Utilization Review Nurse job openings:
Entry Level Utilization Review Nurse jobs near you
Infographic showing various Entry Level Utilization Review Nurse job openings in Rochester, NY as of August 2026, with employment types broken down into 88% Full Time, and 12% Part Time. Highlights an 88% In-person, and 12% Remote job distribution, with an average salary of $86,813 per year, or $41.7 per hour.

Registered Nurse - Ambulatory Procedure Center (APC)

UR Thompson Health

Canandaigua, NY • On-site

$38 - $50/hr

Full-time

Re-posted 17 days ago

Job description

This is a full-time position Monday through Friday, 7 AM-3:30 PM with on call responsibilities to cover nights and weekends.
Responsibilities:
  • Demonstrates skill in the provision of nursing care to patients and families in the ambulatory procedure setting
  • Demonstrates a knowledge base of scientific principles that guide judgment and critical thinking skills through the utilization of the nursing process
  • Demonstrates the ability to work independently and exhibits flexibility in decision making and prioritizing assignments/nursing interventions
  • Demonstrates the ability to develop and maintain collaborative working relationships with all members of the multidisciplinary healthcare team
  • Exhibits leadership skills through active participation in unit- and department-level nursing councils and committees
  • Actively guards the confidentiality of sensitive info including, but not limited to, the patients, staff and health system
  • Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patient

Qualifications:
    • NYS licensed registered nurse required
    • Current BLS certification
    • SGNA certification preferred
    • Telemetry certified or Basic coronary care course within 6 months required
    • Moderate Sedation competency within 3 months for procedure room
    • Current ACLS certification for APU, Recovery, and procedure room

EDUCATION
  • Graduate of an approved school of nursing
  • BSN preferred or achieved within 5 years of hire.

EXPERIENCE
  • Minimum of two (2) years of medical/surgical experience required
  • Cardiac monitoring preferred
  • Critical care preferred

Position Pay Range: $38.00-50.00/hour
Starting Pay: Based on experience
Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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