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Rn Utilization Management information

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$38.5K

$88.3K

$160.8K

How much do rn utilization management jobs pay per year?

As of May 28, 2026, the average yearly pay for rn utilization management in Rochester, NY is $88,290.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,600.00 and $103,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an RN Utilization Management Nurse, and why are they important?

To thrive as an RN Utilization Management Nurse, you need a current RN license, strong clinical assessment skills, and experience in care coordination or case management. Familiarity with utilization review tools, electronic health records, and knowledge of insurance guidelines or InterQual/MCG criteria are typically required. Exceptional communication, critical thinking, and negotiation skills help facilitate collaboration among providers, payers, and patients. These abilities are crucial for ensuring appropriate resource use, compliance with regulations, and optimal patient outcomes.

How does an RN Utilization Management professional typically collaborate with physicians and other healthcare team members?

RN Utilization Management professionals work closely with physicians, case managers, and insurance representatives to ensure patients receive appropriate, high-quality care while managing healthcare costs. They review patient records, communicate clinical findings, and may participate in interdisciplinary meetings to discuss care plans and discharge needs. Building strong relationships and maintaining open lines of communication with the care team is essential for timely authorizations and effective care coordination. This collaborative approach helps optimize patient outcomes and resource utilization.

What are RN Utilization Management nurses?

RN Utilization Management nurses are registered nurses who specialize in reviewing healthcare services to ensure patients receive appropriate and cost-effective care. They evaluate the necessity, efficiency, and quality of medical treatments and procedures, often working with insurance companies, hospitals, or healthcare organizations. Their responsibilities include reviewing patient records, coordinating with clinical staff, making coverage recommendations, and ensuring compliance with healthcare regulations. This role helps manage healthcare costs while maintaining high standards of patient care.

Can you make $200,000 as a nurse?

Registered nurses in utilization management roles typically earn between $70,000 and $120,000 annually, with top earners possibly reaching around $150,000 depending on experience, location, and certifications. Achieving a $200,000 salary usually requires advanced roles, additional certifications, or management positions, which may involve overtime or specialized skills. Salary potential varies based on employer, geographic region, and individual qualifications.

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

AspectRn Utilization ManagementRn Case Management
CertificationsRN license, possibly certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentUtilization review departments, insurance companies, hospitalsCommunity clinics, hospitals, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Both roles require an RN license, but Rn Utilization Management focuses on reviewing the necessity of services, while Rn Case Management emphasizes coordinating patient care. Understanding these differences helps professionals choose the right career path and employers.

What are popular job titles related to Rn Utilization Management jobs in Rochester, NY? For Rn Utilization Management jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Rn Utilization Management jobs in Rochester, NY look for? The top searched job categories for Rn Utilization Management jobs in Rochester, NY are:
Rn Utilization Management jobs near you
Infographic showing various Rn Utilization Management job openings in Rochester, NY as of May 2026, with employment types broken down into 4% As Needed, 47% Full Time, 22% Part Time, 26% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $88,290 per year, or $42.4 per hour.
Surgical Nurse (RN) / OR Surgical RN

Surgical Nurse (RN) / OR Surgical RN

Yale New Haven Health

East Rochester, NY

Full-time

Posted 11 days ago

Yale New Haven Health rating

7.3

Company rating: 7.3 out of 10

Based on 225 frontline employees who took The Breakroom Quiz

290th of 864 rated healthcare providers

Job description

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registered nurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran
Responsibilities
  • 1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registered nurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
  • 2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.
Qualifications
EDUCATION
Graduation from an accredited school of nursing. BSN preferred. All newly hired registered nurses must have current BCLS certification or must obtain within one month of hire.
EXPERIENCE
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
LICENSURE
Licensed and a currently registered nurse in the State of Connecticut. Clinical specialty certification highly encouraged.
SPECIAL SKILLS
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
PHYSICAL DEMAND
Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.
Additional Information
Experienced OR RN's

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