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Remote Utilization Review Manager Jobs in Rochester, NY

Livingston Associates

BIM/VDC Manager

Rochester, NY · On-site +1

$80K - $100K/yr

Review models to ensure adherence to company and project standards * Contribute to the development ... Remote work opportunities available Why Join Hale TIP? * Work on cutting-edge construction ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Rochester, NY

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:

Remote Utilization Review Manager jobs near you

Accounting Specialist - East Coast Based (Remote)

Vino del Sol

Webster, NY • Remote

$19.50 - $26.50/hr

Full-time

Medical, Retirement, PTO

Posted 19 days ago

Job description

Accounting Specialist – Wine Import Business
East Coast Based | Fully Remote
We are a 20+ year wine import company seeking an experienced Accounting Specialist to oversee our day-to-day accounting and financial operations. This is a hands-on role working closely with our operations and accounting team.
Expert-level QuickBooks experience is the most important requirement for this position. Experience with wine importing, distribution, beverage alcohol, or a similar inventory-based business is highly preferred.
Key ResponsibilitiesALL Serve as the company's QuickBooks expert, including imports, journal entries, reconciliations, mapping, maintenance, and troubleshooting.
Oversee and review the work of team members handling AR, AP, order entry, invoicing, compliance, billbacks, and logistics accounting.
Manage banking activity, reconciliations, cash reporting, fraud controls, and payment approvals.
Oversee accounts receivable and collections and review distributor/customer accounts.
Review accounts payable, vendor invoices, freight bills, and weekly payment schedules.
Manage accounting related to inventory, freight, customs, warehousing, and logistics, including proper allocations and journal entries.
Prepare and analyze financial reporting, including P&L, Balance Sheet, AP, cash, open balances, sales, and Budget vs. Actuals.
Assist with monthly and quarterly closes, ensuring supporting schedules and reconciliations are accurate and complete.
Process and review payroll entries, 401(k) reporting, accruals, and PTO tracking.
Assist with annual budgeting, forecasts, and year-end reporting.
Coordinate with outside accountants on tax reporting, 1099s, 1042s, and other annual filings.
Assist with Board of Directors financial reporting and supporting schedules.
Oversee various insurance renewals, audits, and annual business reporting requirements.
Help develop profitability reporting by brand and other management analysis.
Continuously improve and document accounting procedures, controls, checklists, and training materials.
Human Resources
Qualifications
Expert-level QuickBooks experience required.
Strong bookkeeping/accounting background with experience through the financial close.
Controller, Assistant Controller, Senior Bookkeeper, or Accounting Manager experience preferred.
Strong understanding of AP, AR, bank reconciliations, journal entries, accruals, payroll accounting, and financial statements.
Advanced Excel skills and comfort working with data imports and large spreadsheets.
Extremely organized and detail-oriented with the ability to oversee multiple recurring deadlines.
Comfortable working in a hands-on environment and collaborating with a small team.
Experience with wine, beverage alcohol, importing/distribution, inventory, logistics, or consumer products is a significant plus.
Must be based on the East Coast and able to work during Eastern Time business hours.
About the Role
This position is ideal for someone who enjoys being both hands-on in QuickBooks and responsible for the accuracy of the overall accounting function. We are looking for someone who can keep the books clean, ensure deadlines are met, identify issues before they become problems, and provide management with accurate and useful financial information.
To apply: Please submit your resume along with a brief description of your QuickBooks experience and any experience you have in the wine, beverage, importing, distribution, or inventory-based industries.
Benefits: We provide high industry compensation for excellent candidates, health insurance, stock options, 401k; and being a wine business, lots of fun benefits. We would like the person to have at least 5-7 years experience and an accounting or finance degree.
Job category: Finance and Accounting

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