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Remote Utilization Review Manager Jobs in Rochester, NY

Senior Tax Manager

Rochester, NY ยท On-site +1

$140K - $150K/yr

Oversee consolidation, review, and analysis of the global income tax provision and related ... Demonstrated success managing remote/offshore teams and external service providers. Exceptional ...

Showing results 21-40

Remote Utilization Review Manager information

See Rochester, NY salary details

$38.5K

$89.8K

$165.3K

How much do remote utilization review manager jobs pay per year?

As of Sep 7, 2026, the average yearly pay for remote utilization review manager 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 is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

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

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

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

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

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

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

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

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

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

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

Licensed Clinical Social Worker - Full-time Remote Opportunity at Addiction Health Center

Addiction Health Center

Rochester, NY โ€ข Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 20 days ago


Job description

Position Overview

We are seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our team at the Addiction Health Center, located in Rochester, New York. This full-time remote position offers an excellent opportunity to provide critical mental health support while working in a team-oriented, nurturing environment.

About the Organization

The Addiction Health Center specializes in delivering comprehensive and exceptional mental health support tailored to a broad spectrum of patient needs. Our team is composed of skilled professionals committed to fostering a safe space for healing and personal development. We pride ourselves on our inclusive approach to mental health, ensuring that every voice within our community is heard and valued.

Work Environment

This role is primarily remote, which allows for flexibility and comfort while performing your duties. While the Addiction Health Center operates within a structured framework, we encourage teamwork and open communication among staff members. Youโ€™ll collaborate with colleagues via virtual platforms to discuss patient care strategies and ensure alignment on treatment protocols.

Key Responsibilities
  • Act as a liaison between families and outpatient providers, facilitating effective communication to support patient care.
  • Engage with insurance companies for essential pre-certification processes and to manage utilization effectively.
  • Participate in comprehensive discharge and aftercare planning to ensure continuity of care and support for each client post-treatment.
  • Provide therapeutic meal support, guiding clients towards developing a healthy relationship with food in a respectful and affirming manner.
  • Offer empathetic and culturally competent care, tailored to meet the unique needs of clients based on their intersecting identities, to foster an inclusive environment that promotes healing.
Patient Population / Client Focus

Our focus is primarily on clients struggling with addiction and mental health issues, including older adults who face unique challenges in these areas. We recognize the diverse backgrounds and experiences of our clients, allowing for tailored approaches in therapeutic interventions that acknowledge and respect their histories.

Qualifications
  • A Masterโ€™s degree in Social Work from an accredited institution is required.
  • Possession of a valid LCSW license in the state of New York is essential.
  • Experience working with older adults is highly preferred.
  • Strong clinical and diagnostic skills are crucial for this position.
  • Candidate must exhibit excellent communication and interpersonal skills to effectively interact with clients, colleagues, and external partners.
  • Ability to work independently as well as collaboratively within a team setting.
Preferred Experience

While the required qualifications focus on licensing and degree, preferred experience includes strong background in behavioral health settings, particularly those catering to addiction recovery and support services. Familiarity with electronic health record (EHR) systems and management of client care documentation will enhance your capability in this role.

Compensation and Benefits

The compensation for this position ranges from $90,000 to $105,000 per year, commensurate with experience and qualifications. In addition to competitive pay, we offer a comprehensive benefits package which includes medical, dental, and vision insurance plans to maintain your well-being. Additional benefits include a 401(k) retirement plan with company matching, flexible spending accounts, life insurance, and short-term disability coverage for enhanced financial security.

Career Growth Opportunities

At the Addiction Health Center, we believe in investing in our employees' futures. We offer opportunities for professional development and continuing education, which support your growth within our organization. You will also be encouraged to take on leadership roles and contribute to best practices in the field of social work, collaborating with diverse teams on innovative projects.

Why Join Our Team

Joining the Addiction Health Center allows you to become part of a mission-driven organization dedicated to making a positive impact in the lives of our clients. By delivering compassionate, evidence-based care, you will help clients on their journey towards recovery and empowerment. If you are passionate about social work and want to be part of a supportive network that values your contributions, we encourage you to apply.

Application Information

If you are interested in taking the next step in your career and making a difference, please submit your application today. We look forward to welcoming a dedicated and talented Licensed Clinical Social Worker to our compassionate team at the Addiction Health Center.