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Manager Utilization Management Jobs in Rochester, NY

Highland Hospital

RN Case Manager PC/FM

Rochester, NY

$37 - $45/hr

... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...

Highland Hospital

RN Care Coordinator

Rochester, NY · On-site

$77K - $93K/yr

... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager may manage clinical aspects of patient ...

Cooper Companies

Manager, Facilities

Victor, NY · On-site

$101K - $144K/yr

Effective utilization, management, growth and development of assigned team (including mailroom, reception, facility coordinator, security, cleaning crew and others as may be assigned) * Oversee the ...

CooperCompanies

Manager, Facilities

Victor, NY · On-site

Effective utilization, management, growth and development of assigned team (including mailroom, reception, facility coordinator, security, cleaning crew and others as may be assigned) * Oversee the ...

Mvphealthcare

Concurrent Review - RN

Rochester, NY · Remote

$69K - $92K/yr

Ideal for experienced RNs looking to expand into utilization management, this position provides exposure to complex clinical decision-making, healthcare policy interpretation, and care coordination ...

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All JobsManager Utilization Management JobsManager Utilization Management Jobs in Rochester, NY

Manager Utilization Management information

See Rochester, NY salary details

$38.5K

$89.8K

$165.3K

How much do manager utilization management jobs pay per year?

As of Jun 21, 2026, the average yearly pay for manager utilization management in Rochester, NY is $89,798.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $108,000.00 per year, depending on experience, location, and employer.

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

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Rochester, NY? The most popular types of Utilization Management jobs in Rochester, NY are:
What are popular job titles related to Manager Utilization Management jobs in Rochester, NY? For Manager Utilization Management jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Rochester, NY look for? The top searched job categories for Manager Utilization Management jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Manager Utilization Management jobs? Cities near Rochester, NY with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Rochester, NY as of June 2026, with employment types broken down into 1% As Needed, 96% Full Time, 1% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $89,798 per year, or $43.2 per hour.
RN Case Manager PC/FM

RN Case Manager PC/FM

Highland Hospital

Rochester, NY

$37 - $45/hr

Other

Posted 8 days ago

Highland Hospital (New York) rating

7.7

Company rating: 7.7 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

209th of 1,001 rated hospitals

Job description

18247BR

Title:

RN Case Manager PC/FM

Department/Cost Center:

891 - Highland Family Medicine

Job Description:

Under general direction of the Clinical Manager, the RN Care Manager’s central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with the interdisciplinary medical team in the provision of patient care. May participate in supervision of other clinical staff members.

Salary Range:

$37.00 - $45.00 an hour

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Auto req ID:

18247BR

Job Requirements:

Qualifications:

Education: Fulfilled the educational requirements to be a licensed RN in NYS. BSN preferred.

Experience: Three to five years of professional nursing experience. Outpatient primary care and/or pediatric (if applicable) experience preferred. Progressive clinical experience including: community health, care management, and/or disease management is preferred. Experience working as a member of a multi-disciplinary team is required. Supervisory experience is desirable. Experience in data analysis and chronic illness registries. A satisfactory equivalent of education and experience will be considered.

License/Certification Required: registered nursing license. Current CPR certification required (AHA BLS for health care providers or ARC CPR for professional health care providers). Successful completion of medication proficiency examination. driver’s license and the ability to travel.

Skills: Clinical expertise as it relates to chronic disease management. Analytical. Builds effective relationships; builds trust and commitment with practice physicians, the health care team, patients, and their caregivers. Knowledge of nursing processes, health care systems, and community resources. Understanding of health care technology. Familiarity with state law on nursing care, nurse practice guidelines, and clinical policies and procedures. Knowledge of wellness/illness, growth and development, human behavior, psychosocial factors, and alternative health care treatments. Knowledge of chart/medical record documentation requirements and federal/state laws related to release of health care information. Basic proficiency with Microsoft Outlook, Word, and Excel.

Population Served:

Family Medicine Neonate through geriatric

Internal Medicine Adolescent through geriatric

OB/GYN Adolescent through geriatric

Employment Status:

Full-Time

Hours/Week:

40 hours per week

Posting Title:

RN Care Manager

City:

Rochester

Work Shift:

Days

Area of Interest:

Nurses

The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.

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