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Remote Optum Utilization Review Jobs in Rochester, NY

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · Remote

$60 - $65/hr

While this is a remote position, candidates must reside in or be willing to relocate to one of the ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

IDEX

Assistant Controller

West Henrietta, NY · On-site +1

... reviews Reports key performance indices (KPI) for Operations, analyzes variances and provides ... This position is a remote role; however, we are seeking candidates who reside within reasonable ...

All JobsOptum Utilization Review JobsRemote Optum Utilization Review JobsRemote Optum Utilization Review Jobs in Rochester, NY

Remote Optum Utilization Review information

See Rochester, NY salary details

$21

$41

$68

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

As of Jul 31, 2026, the average hourly pay for remote optum 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 Remote Optum Utilization Review vs Remote UnitedHealthcare Utilization Review?

AspectRemote Optum Utilization ReviewRemote UnitedHealthcare Utilization Review
CredentialsLicenses in relevant states, certifications like CCM or CRC often preferredLicenses in relevant states, certifications like CCM or CRC often preferred
Work EnvironmentRemote, home-based with flexible hoursRemote, home-based with flexible hours
Employer & IndustryOptum, healthcare services and utilization managementUnitedHealthcare, health insurance and utilization review

Both roles involve reviewing healthcare claims and authorizations remotely, requiring similar credentials and work environments. The main difference lies in the employer and specific healthcare focus: Optum specializes in healthcare services and utilization management, while UnitedHealthcare focuses on health insurance and claims review. Candidates often compare these roles to determine the best fit based on employer and industry specialization.

How does a Remote Optum Utilization Review nurse typically collaborate with multidisciplinary teams while working from home?

As a Remote Optum Utilization Review nurse, collaboration with multidisciplinary teams is primarily conducted through secure digital platforms, including video calls, emails, and electronic health record systems. You’ll regularly communicate with physicians, social workers, case managers, and other healthcare providers to review patient cases, coordinate care plans, and ensure compliance with clinical guidelines. Despite working remotely, maintaining clear and timely communication is essential for effective patient advocacy and decision-making. Team meetings and case discussions are scheduled virtually, fostering a supportive environment and ensuring you stay connected to the broader healthcare team.

What is a Remote Optum Utilization Review position?

A Remote Optum Utilization Review position involves working for Optum, a healthcare services company, to evaluate medical records and determine the necessity and appropriateness of healthcare services. Employees in this role review clinical documentation to ensure that treatments meet established guidelines and help to manage healthcare costs while ensuring patient care is not compromised. The position is remote, meaning you can work from home or another location outside of a traditional office. Utilization review professionals often interact with healthcare providers, insurance companies, and patients, using their clinical expertise to make informed decisions.

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

To thrive as a Remote Optum Utilization Review Nurse, you need a current RN license, strong clinical judgment, knowledge of utilization management, and experience in case review or discharge planning. Proficiency with medical review software, electronic health records, and familiarity with UM guidelines such as InterQual or Milliman is typically required. Exceptional communication, attention to detail, and critical thinking are vital soft skills for effective collaboration and decision-making in a remote environment. These skills ensure accurate assessments, regulatory compliance, and optimal patient outcomes while maintaining efficiency in a virtual workflow.
What are the most commonly searched types of Optum Utilization Review jobs in Rochester, NY? The most popular types of Optum Utilization Review jobs in Rochester, NY are:
What job categories do people searching Remote Optum Utilization Review jobs in Rochester, NY look for? The top searched job categories for Remote Optum Utilization Review jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Remote Optum Utilization Review jobs? Cities near Rochester, NY with the most Remote Optum Utilization Review job openings:
Remote Optum Utilization Review jobs near you
Infographic showing various Remote Optum Utilization Review job openings in Rochester, NY as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

LCSW Clinical Supervisor - Remote

Athena

Rochester, NY • Remote

$60 - $65/hr

Part-time

Re-posted 17 days ago

Job description

While this is a remote position, candidates must reside in or be willing to relocate to one of the following states prior to their start date:

Colorado, Connecticut, District of Columbia (Washington, D.C.), Florida, Massachusetts, Maryland, North Carolina, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington

Athena Mental Health is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges.  We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities.
 
Here at Athena, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our clients’ overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. 
 
Are You a Good Fit For Us?
We are currently seeking professional and compassionate Clinical Supervisors to join our growing team. Flexible hours are provided with the need of one weekend day and some evenings. In-person and telehealth sessions are conducted by our clinicians.
Responsibilities
  • Provide weekly clinical supervision to therapists as assigned, and document supervision sessions in a timely manner
  • Complete and maintain NYS licensure paperwork for supervisees as applicable
  • Assist with the development and facilitation of clinical training for staff in partnership with the leadership team
  • Work with the Clinical Director to cover administrative tasks as needed, including performance management of assigned therapists when necessary
  • Perform ongoing review of high-risk cases and provide clinical solutions as appropriate
  • Engage in the Utilization Review process for assigned cases every month
  • Respond to clinical crises and other clinical issues brought forward by supervisees
  • Help develop and improve clinical policies and procedures on an ongoing basis to support overall success of the program
  • Maintain a reduced caseload of therapy clients; complete all required clinical documentation promptly, including comprehensive assessments, treatment plans, and progress notes
Qualifications
  • NYS Independently Licensed Mental Health Provider (PhD, LCSW, LCSW-R, etc.)
  • Leadership experience in a mental health clinic setting
  • Bilingual in English and Spanish is preferred, but not required 
  • Previous experience using computerized appointment scheduling systems and/or electronic Medical Record Systems
  • Knowledgeable in NYS OMH Outpatient Clinic regulations
  • Knowledgeable in HIPAA Regulations
This is a fee-for-service role where you are compensated at a base rate per supervisory session.
Working Conditions
This position will be located at either the Manhattan office at 33 West 60th Street, New York, NY 10023, Suite 600, the Bronx office at 2825 Third Avenue, Suite 402, Bronx, NY 10455, 1299 Portland Ave, Suite 1, Rochester, NY 14621, or remotely. This is a professional work environment where a computer, desk, chair, and office supplies will be essential.
 
Physical Requirements
The physical demands described here are representative of those that must be met by an employee in order to successfully perform the essential functions of the role above. While performing the duties of this job, the employee is regularly required to hear and speak on the phone or through virtual telehealth sessions conducted on a computer throughout the day, stand and sit for an extended period of time and be able to write and answer emails in addition to carrying objects no greater than 25 pounds, when needed.
 
Direct Reports
This position has direct reports.
 
Athena is an Equal Opportunity Employer.
 
Note: We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions. 

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.