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Free Utilization Review Training Jobs in Rome, NY

KPH Healthcare Services

Pharmacy Resident

East Syracuse, NY · On-site

$60K - $65K/yr

... based upon review of utilization data, current trends, and industry offerings. Perform cost ... Complete all mandatory KPH, state, and federal training programs. * Perform other related duties as ...

UCP Madison County

Fiscal Intermediary Associate

Utica, NY · On-site

$17.14 - $20/hr

... the hiring and training of staff. * Provide the Self-Direction individuals with copies of all ... Monitor the person's budget utilization and perform monthly financial statement oversight, review ...

ProAct

Pharmacy Resident

East Syracuse, NY

$60K - $65K/yr

... based upon review of utilization data, current trends, and industry offerings. Perform cost ... Complete all mandatory KPH, state, and federal training programs. * Perform other related duties as ...

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Free Utilization Review Training information

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$65

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

As of Aug 16, 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.

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.

What cities near Rome, NY are hiring for Free Utilization Review Training jobs?

Cities near Rome, NY with the most Free Utilization Review Training job openings:

Free Utilization Review Training jobs near you

Pharmacy Resident

KPH Healthcare Services

East Syracuse, NY • On-site

$60K - $65K/yr

Full-time

Re-posted 25 days ago

KPH Healthcare Services rating

6.8

Company rating: 6.8 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Overview
Scope of Responsibilities: Relies on experience and professional judgment to plan, accomplish, and report on assigned tasks and goals that meet the clinical needs of ProAct clients and members.
Job Summary: At the end of the one-year program, the resident will possess knowledge on clinical account management, drug utilization management, data analysis, formulary management, and Medication Therapy Management (MTM). They will be responsible for the execution of clinical programs interacting with patients and prescribers to improve health outcomes while lowering client costs.
Responsibilities
  • Identify, develop, and execute clinical and cost savings programs for clients based upon review of utilization data, current trends, and industry offerings. Perform cost avoidance analysis to demonstrate a return on ProAct and/or client investment.
  • Perform patient and prescriber outreach to complete clinical interventions, including but not limited to leveraging the following software and programs: PA Hub/PromptPA, Clinical Optimization, Diabetes Management, Medication Therapy Management, and Aprexis.
  • Maintain and update clinical criteria associated with prior authorization software as it relates to formulary changes.
  • Review prior authorizations and appeals against the formulary and clinical criteria for ProAct members as needed.
  • Develop and present educational programs to ProAct clients and other business partners.
  • Monitor for compliance with all policies and procedures and regulatory issues impacting role in the organization.
  • Leverage available resources (i.e., UpToDate, Clinical Pharmacology, Pharmacist Letter, IPD Analytics, Pipeline/Trend Reporting) to remain current on industry topics.
  • Collaborate with the Kinney Patient Care Center on communication and reporting relating to on-site flu clinics for ProAct clients.
  • Complete all mandatory KPH, state, and federal training programs.
  • Perform other related duties as assigned.

Qualifications
Educational Requirements:
  • PharmD Degree from an accredited College of Pharmacy

Compensation:
$60,000 - 65,000 per year.
The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.
KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.

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