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Free Utilization Review Training Jobs in Rome, NY

Lthc

Medical Director, Commercial

Utica, NY · On-site

Utilization review activities include: reviews of requests for broad range of medical services ... Assists with training medical director colleagues and nursing staff, including leadership of ...

Lthc

Medical Director, Commercial

Utica, NY

Utilization review activities include: reviews of requests for broad range of medical services ... Assists with training medical director colleagues and nursing staff, including leadership of ...

Lthc

Medical Director, Commercial

Utica, NY · On-site

Utilization review activities include: reviews of requests for broad range of medical services ... Assists with training medical director colleagues and nursing staff, including leadership of ...

Lthc

Utilization Management Services Rep I

Utica, NY

$16.25 - $22.25/hr

Provide one-on-one support, coaching, and training to UM Services Reps. * Collaborates with other ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.

Lthc

Utilization Management Services Rep I

Utica, NY · On-site

$16.25 - $22.25/hr

Provide one-on-one support, coaching, and training to UM Services Reps. * Collaborates with other ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.

UCP Madison County

Behavioral Health Provider

Utica, NY · On-site

$60K - $80K/yr

Participate in utilization review, quality improvement activities, and data-driven care initiatives ... Maintain professional competency through ongoing training, continuing education, and participation ...

Upstate Cerebral Palsy

Behavioral Health Provider

Utica, NY · On-site

$60K - $80K/yr

Participate in utilization review, quality improvement activities, and data-driven care initiatives ... Maintain professional competency through ongoing training, continuing education, and participation ...

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All JobsFree Utilization Review Training JobsFree Utilization Review Training Jobs in Rome, NY

Free Utilization Review Training information

See Rome, NY salary details

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How much do free utilization review training jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for free utilization review training in Rome, NY is $40.03, according to ZipRecruiter salary data. Most workers in this role earn between $31.63 and $45.96 per hour, depending on experience, location, and employer.

What is free utilization review training?

Free utilization review training refers to educational programs or courses that teach individuals the fundamentals of utilization review without requiring payment. Utilization review is a process used in healthcare to assess the necessity, efficiency, and appropriateness of medical services, procedures, or admissions. These free training options are often available online and can help nurses, case managers, or other healthcare professionals gain the skills needed to pursue roles in utilization management. Training typically covers topics such as clinical guidelines, insurance protocols, and regulatory compliance. Completing such training can enhance career opportunities in healthcare case management and insurance settings.

What is the difference between Free Utilization Review Training vs Utilization Review Nurse?

AspectFree Utilization Review TrainingUtilization Review Nurse
CredentialsTypically no formal credentials required; focus on training programsRegistered Nurse (RN) license required, with possible certifications like CCM or UR-specific credentials
Work EnvironmentTraining sessions, online courses, workshopsHospitals, insurance companies, healthcare facilities
Employer & Industry UsageUsed for skill development and certification prepPerforming reviews, making coverage decisions, ensuring appropriate care

Free Utilization Review Training provides foundational knowledge and skills for those interested in entering or advancing in utilization review roles. In contrast, a Utilization Review Nurse is a licensed healthcare professional actively performing review duties in clinical settings. The training is often a prerequisite or supplement to the nurse's practical work, which requires licensure and clinical experience.

How to become a utilization reviewer?

To become a utilization reviewer, typically one needs a healthcare-related degree such as nursing, health administration, or a related field, along with experience in clinical or insurance settings. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong analytical skills, knowledge of medical policies, and familiarity with electronic health records are also important.

How to make an extra $2000 a month as a nurse?

Nurses can increase their income by pursuing specialized certifications such as case management or utilization review, which can lead to higher-paying roles. Working additional shifts, taking on per diem or travel nursing assignments, or engaging in telehealth services can also help earn extra income, especially if they have skills in utilization review or case management. Developing expertise in these areas can open opportunities for higher-paying side jobs or part-time roles.

Can you get a job with a free certificate?

Having a free utilization review training certificate can help demonstrate foundational knowledge for roles in utilization review, but employers often prefer candidates with industry-recognized certifications or relevant work experience. A free certificate alone may not be sufficient to qualify for a job, as many positions require specific credentials or licensing. It can serve as a useful starting point to build skills and enhance your resume.

Where to get utilization review certification online free?

Free online utilization review certification programs are limited, but some organizations and platforms offer free introductory courses or resources to learn about utilization review processes. However, obtaining a recognized certification typically requires paid courses or exams from accredited bodies such as the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or other professional organizations, which may offer scholarships or discounts. It is important to verify the credibility of any free program to ensure it meets industry standards for certification.

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

To thrive as a Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and knowledge of insurance and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and possibly certifications like Certified Utilization Review Nurse (CURN) are typically expected. Excellent communication, analytical thinking, and attention to detail are standout soft skills in this position. These abilities are crucial for ensuring appropriate patient care, compliance, and cost-effective healthcare delivery.

What are some common challenges faced by professionals during utilization review training, and how can they be overcome?

During utilization review training, professionals often encounter challenges such as adapting to complex healthcare regulations, learning to interpret medical records efficiently, and effectively applying clinical guidelines to decision-making. Overcoming these challenges requires strong attention to detail, ongoing engagement with training modules, and seeking mentorship from experienced utilization review nurses or case managers. Actively participating in case discussions and staying updated with industry standards can also help trainees build confidence and competence for a successful career in utilization review.
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Free Utilization Review Training jobs near you

Utilization Quality Review - VNA - Full Time - Days

Mohawk Valley Health Systems

Utica, NY • On-site

$74K - $100K/yr

Full-time

Posted 29 days ago

Job description

Job Summary
The Quality Improvement Reviewer/Educator is responsible for developing, implementing, and evaluating Home Care Services quality improvement/staff education practices to ensure that quality patient centered home care services are provided. This includes the maintenance of, and adherence to each agency(s) policies and procedures governing Home Care Service agencies to ensure compliance with State & Federal Regulations.
Core Job Responsibilities
  • In collaboration with the Director of Quality Improvement, maintains records and reports to support and document Utilization Review/Quality Improvement activities.
  • In collaboration with the Director of Quality Improvement, responsible for completing record audits for home care/member services per state and federal regulations.
  • In collaboration with the Director of Quality Improvement, responsible for compiling and maintaining audit record statistics and utilizes outcome reports to educate front line staff to improve patient/member outcomes.
  • In collaboration with the staff education supervisor, serves as educational resource to home care services clinical staff.
  • In collaboration with staff education supervisor, educates agency personnel on quality improvement and corporate compliance programs, clinical practice, and how their roles, responsibilities and actions relate to the process.
  • In collaboration with the staff education supervisor, educates home care services staff on clinical field practice per agency(s) regulations.
  • In collaboration with the Director of Quality Improvement, reports to the Professional Advisory Committee (PAC) on a quarterly basis.
  • Supports the Agency's Compliance Program, coordinating compliance audits and report findings to internal compliance committee.
  • In collaboration with the Director of Quality Improvement, and Director of Patient Services, completes the process for receiving, documenting, tracking, investigation on all home care services complaints and coordinates information per agency standards.
  • Conduct review of claim data and medical records to make decisions on the coverage, medical necessity, utilization, and appropriateness of care per company policy and standards, as well as accepted medical standards of care.
  • Prepares monthly and/or quarterly reports of utilization management activities with statistical analysis performed.
  • Ensures that grievances and appeals are processed timely within the time frames of regulations and company policy.
  • Maintains a safe environment by adhering to the Agency's Safety Program.
  • Demonstrates effectiveness in planning and implementing the performance improvement program to meet the needs of the agency(s).
  • In collaboration with the Director of Quality Improvement/Privacy Officer in developing, implementing, reviewing, revising, and monitoring facility-wide performance improvement activities.
  • Participates in the development and review of agency(s) policies & procedures.
  • Knowledgeable in the current methodology and practices and maintains awareness of changes in the regulations and requirements by accrediting bodies involving all home care services agency(s).
  • In collaboration with the education supervisor, completes joint competency field visits with staff per agency(s) regulations.
  • In collaboration with the education supervisor, completes electronic medical record (EMR) staff training per agency(s) needs.
  • In collaboration with the education supervisor, participates in clinical staff's orientation process as scheduled.
  • In collaboration with the staff educator, completes and presents individual and group educational training sessions per agency(s) need under the direction of the staff education supervisor.
  • Performs other duties as required or assigned.

Education/Experience Requirements
Required:
  • An associate's degree in applied science with a current NYS registered nursing license
  • 1 years of home care experience.

Licensure/Certification Requirements
Required:
  • Valid New York State driver's license

Disclaimer
Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.
Job Details
Req Id 97789
Department CLINICAL SUPPORT
Shift Days
Shift Hours Worked 8.50
FTE 1
Work Schedule SALARIED GENERAL
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $74,000 - $100,000 Annually

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