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Full Time Optum Health Utilization Review Jobs in Rochester, NY

Lthc

Utilization Management Services Rep I

Rochester, NY · On-site

$15.75 - $21.50/hr

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.

Lthc

Utilization Management Services Rep I

Rochester, NY · On-site

$15.75 - $21.50/hr

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare ... review and creation of desk level procedures, acting as a subject matter expert for UM Services.

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Showing results 21-40

All JobsOptum Health Utilization Review JobsFull Time Optum Health Utilization Review JobsFull Time Optum Health Utilization Review Jobs in Rochester, NY

Full Time Optum Health Utilization Review information

See Rochester, NY salary details

$21

$41

$68

How much do full time optum health utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for full time optum health utilization review in Rochester, NY is $41.72, 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.

What is the difference between Full Time Optum Health Utilization Review vs Full Time Medical Coder?

AspectFull Time Optum Health Utilization ReviewFull Time Medical Coder
CertificationsUtilization Review Certification, CPC or RHIT often preferredCertified Coding Specialist (CCS), CPC
Work EnvironmentHealthcare facilities, insurance companies, remote optionsHospitals, clinics, remote coding roles
Job FocusReviewing medical necessity, authorizations, and insurance claimsTranslating medical records into standardized codes
Industry UsageCommon in health insurance and managed careWidely used in healthcare billing and documentation

While both roles are integral to healthcare operations, Full Time Optum Health Utilization Review focuses on assessing the necessity of care and insurance approvals, whereas Full Time Medical Coder specializes in accurately coding medical records for billing. Understanding these differences helps job seekers identify the right career path in healthcare administration and coding fields.

What are the most commonly searched types of Optum Health Utilization Review jobs in Rochester, NY?

The most popular types of Optum Health Utilization Review jobs in Rochester, NY are:

What are popular job titles related to Full Time Optum Health Utilization Review jobs in Rochester, NY?

For Full Time Optum Health Utilization Review jobs in Rochester, NY, the most frequently searched job titles are:

What job categories do people searching Full Time Optum Health Utilization Review jobs in Rochester, NY look for?

The top searched job categories for Full Time Optum Health Utilization Review jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Full Time Optum Health Utilization Review jobs?

Cities near Rochester, NY with the most Full Time Optum Health Utilization Review job openings:

Full Time Optum Health Utilization Review jobs near you
Infographic showing various Full Time Optum Health Utilization Review job openings in Rochester, NY as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

Registered Nurse (RN) Case Manager I (Full-Time, Days) - Home Care

Rochester Regional Health

Newark, NY • On-site

Full-time

Re-posted 4 days ago

Rochester Regional Health rating

7.3

Company rating: 7.3 out of 10

Based on 218 frontline employees who took The Breakroom Quiz

307th of 888 rated healthcare providers

Job description

SUMMARY
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: Homecare
SCHEDULE: Monday-Friday, 8:00am-4:30pm
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 experienced 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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