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Remote Insurance Utilization Review Jobs in Rochester, NY

Lthc

Manager of Credentialing Operations

Rochester, NY · Remote

$71K - $129K/yr

... and utilization of personnel and equipment. Develops and implements department goals and ... Participates in budget/invoice reviews as needed. * Consistently demonstrates high standards of ...

Lthc

Manager of Credentialing Operations

Rochester, NY · Remote

$71K - $129K/yr

... and utilization of personnel and equipment. Develops and implements department goals and ... Participates in budget/invoice reviews as needed. * Consistently demonstrates high standards of ...

Lthc

Manager of Credentialing Operations

Rochester, NY · Remote

$71K - $129K/yr

... and utilization of personnel and equipment. Develops and implements department goals and ... Participates in budget/invoice reviews as needed. * Consistently demonstrates high standards of ...

centralins

Middle Market Underwriter

Rochester, NY · Remote

Remote Position type: Full time - salary We're a team of employees passionate about delivering best ... Lead reviews on larger accounts exceeding letter of authority * Keep current on state/territory ...

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Remote Insurance Utilization Review information

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$41

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How much do remote insurance utilization review jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote insurance 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 a remote insurance utilization review?

Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.

What skills and qualifications are needed for a remote insurance utilization review specialist?

To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.

How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?

Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.

What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed across insurance sectors to process and validate claims

Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.

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

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

What are popular job titles related to Remote Insurance Utilization Review jobs in Rochester, NY?

For Remote Insurance Utilization Review jobs in Rochester, NY, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Utilization Review jobs in Rochester, NY look for?

The top searched job categories for Remote Insurance Utilization Review jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Remote Insurance Utilization Review jobs?

Cities near Rochester, NY with the most Remote Insurance Utilization Review job openings:

Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Rochester, NY as of August 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

Senior Project Manager- Commercial Construction Projects

System One

Rochester, NY • Remote

$130K - $165K/yr

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted yesterday

Job description

Job Title: Senior Project Manager- Commercial Construction Projects Location: Rochester, New York Type: Direct Hire Compensation: $130,000.00 - $165,000.00 Contractor Work Model: Hybrid – onsite and remote

Overview The Senior Project Manager, Project Delivery (SPM) will oversee all aspects of the implementation of the Contract for a Delivery Project, or a portion of an IS Delivery Project. They are responsible for managing the financial aspects of the Project, Subcontractors, Vendors, Client relationships and delivering a safe, quality outcome the meets or exceeds Company commitments.

Responsibilities

  • Oversee all aspects of the implementation of construction contracts for commercial projects, ensuring safety, quality, timeliness, and budget adherence.
  • Manage project teams, subcontractors, vendors, and client relationships to deliver successful project outcomes.
  • Maintain a safe work environment through active site planning, safety protocol reviews, site walks, and safety meetings.
  • Lead project scope management, including setting up project management systems (Procore), and overseeing change management, documentation, and reporting.
  • Negotiate and authorize vendor purchase orders and subcontracts to meet project milestones and budget targets.
  • Establish and manage project schedules, including baseline schedules focusing on energy savings and key milestones.
  • Prepare, review, and distribute monthly project reports, cost assessments, and quality assurance documentation.
  • Ensure proper change management procedures, including RFIs, drawing revisions, and client directives are followed accurately and promptly.
  • Facilitate effective communication with all project stakeholders through meeting agendas, minutes, and risk mitigation planning.
  • Build and maintain strong relationships with subcontractors, vendors, and clients to achieve predictable, successful project delivery.
  • Manage and develop project management staff to ensure consistent performance and growth.

Requirements

  • Bachelor’s degree in Construction Management, Engineering, or related field.
  • 8+ years of experience in commercial construction project management.
  • Effective communication skills—verbal, written, and presentation.
  • Proven leadership ability with a resourceful approach to resolving issues and motivating teams.
  • Ability to multitask and perform additional duties as necessary.
  • Experience managing projects in healthcare, higher education, or industrial campus facilities is preferred.
  • OSHA 30, CPR, and First Aid certifications are highly desirable.
  • Experience working with mechanical or electrical contractors is a plus.

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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