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Remote Utilization Management Jobs in Rochester, NY

... management of assigned therapists when necessary * Perform ongoing review of high-risk cases and ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

Remote Utilization Management information

See Rochester, NY salary details

$21

$41

$68

How much do remote utilization management jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote utilization management 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 remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

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 cities near Rochester, NY are hiring for Remote Utilization Management jobs?

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

Infographic showing various Remote Utilization Management job openings in Rochester, NY as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

Remote Licensed Clinical Social Worker at Atlantic Academy, RTC

Atlantic Academy, RTC

Rochester, NY • Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 5 days ago


Job description

Position Overview

Atlantic Academy, RTC is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) for a full-time remote position, primarily focused on providing essential mental health support. In this critical role, you will be responsible for developing strong therapeutic relationships with clients, facilitating their healing journey, and providing tailored interventions that empower individuals to achieve their mental health goals.

About the Organization

At Atlantic Academy, RTC, we specialize in delivering exceptional mental health support catered to a diverse spectrum of needs. Our professionals cultivate a safe and nurturing environment where personal growth, healing, and empowerment are prioritized. We believe in an integrated approach to mental health care, ensuring our practices reflect the values of inclusivity, respect, and dignity for all clients.

Work Environment

This role provides a unique opportunity to work remotely, allowing you to balance professional responsibilities and personal life effectively. As a member of our community health clinic team, you will enjoy a supportive work culture that recognizes and values your contributions. Regular team meetings and training sessions are conducted virtually to promote collaboration and professional development.

Key Responsibilities
  • Act as a liaison between clients, their families, and outpatient providers to facilitate comprehensive care and support.
  • Engage with various insurance companies for pre-certification and utilization management, ensuring that clients receive necessary coverage for their treatment.
  • Participate actively in discharge and aftercare planning, preparing clients for successful transitions and support post-treatment.
  • Provide therapeutic meal support, modeling healthy relationships with food, encouraging mindful eating practices, and fostering positive body image.
  • Deliver safe, empathetic, and affirming care tailored to each client's unique circumstances, particularly taking into account their intersecting identities and experiences.
Patient Population / Client Focus

As a Licensed Clinical Social Worker at Atlantic Academy, you will work with a diverse client population that includes children, adolescents, and adults facing various mental health challenges. Through our remote community health clinic, you will engage individuals from different backgrounds, helping them cope with mental health issues including depression, anxiety, trauma, and more. Your role is essential in enhancing their quality of life and promoting recovery.

Qualifications
  • A Master's degree in Social Work from an accredited institution is required.
  • Must hold a valid Licensed Clinical Social Worker (LCSW) license in the state of New York.
  • Experience working with older adults and understanding the unique challenges they face in mental health.
  • Exceptional clinical and diagnostic skills to assess and formulate treatment plans effectively.
  • Outstanding communication and interpersonal skills to foster strong relationships with clients and team members.
  • A willingness to work independently and as part of a collaborative team environment.
Preferred Experience
  • A background in working with patients facing complex trauma or multi-faceted mental health concerns is highly preferred.
  • Familiarity with telehealth technologies and electronic health records systems to document sessions and coordinate care efficiently.
  • Knowledge of community resources and local mental health services that can assist clients in their recovery journey.
Compensation and Benefits

We offer a competitive salary range of $90,000 to $105,000 per year, commensurate with experience and qualifications. In addition to a competitive salary, you will receive a robust benefits package that includes:

  • Comprehensive medical, dental, and vision insurance.
  • 401(k) retirement plan with employer matching contributions.
  • Flexible spending accounts for healthcare and dependent care expenses.
  • Life insurance and short-term disability coverage for added peace of mind.
  • A supportive work environment that encourages professional development and growth.
Career Growth Opportunities

At Atlantic Academy, we are committed to the professional advancement of our staff. As a Licensed Clinical Social Worker, you will have opportunities for continued education, training in specialized therapeutic techniques, and leadership roles within the organization. We encourage you to pursue further certifications and qualifications to enhance your skills and impact on our clients.

Why Join Our Team

Joining Atlantic Academy means becoming part of a forward-thinking team that is passionate about mental health advocacy and patient care. Here, your insights and contributions matter. You will work alongside a team of skilled professionals who share your commitment to empowering individuals and enhancing mental health outcomes across the community.

Application Information

If you are a dedicated Licensed Clinical Social Worker looking to make a significant impact in the lives of others while enjoying the flexibility of remote work, we encourage you to apply today! Please submit your resume and a cover letter detailing your qualifications and motivation for joining our team.