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Utilization Care Manager Jobs in Rochester, NY (NOW HIRING)

Highland Hospital

RN Care Manager

Rochester, NY · On-site

$37 - $45/hr

Under general direction of the Clinical Manager, the RN Care Manager's central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and ...

Highland Hospital

RN Case Manager PC/FM

Rochester, NY

$37 - $45/hr

Under general direction of the Clinical Manager, the RN Care Manager's central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and ...

Highland Hospital

RN Care Coordinator

Rochester, NY · On-site

$77K - $93K/yr

... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager may manage clinical aspects of patient ...

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All JobsUtilization Care JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Rochester, NY

Utilization Care Manager information

See Rochester, NY salary details

$38.5K

$89.8K

$165.3K

How much do utilization care manager jobs pay per year?

As of Jul 7, 2026, the average yearly pay for utilization care 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 does a utilization manager do?

A utilization care manager evaluates healthcare services to ensure they are necessary, appropriate, and cost-effective. They review patient cases, coordinate with healthcare providers, and use medical records and guidelines to optimize resource use and improve patient outcomes.

How does a Utilization Care Manager typically collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What are Utilization Care Managers?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience in patient communication, medical records, and office procedures, which can serve as a foundation for advanced healthcare roles. However, career growth may require additional certifications or training.

What jobs pay 4000 a week without a degree?

Utilization Care Managers typically do not earn $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include skilled trades such as commercial pilots, real estate brokers, or sales managers, which may require licensing or extensive experience. Most jobs paying this amount without a degree involve specialized skills, certifications, or significant experience in the field.

What are the key skills and qualifications needed to thrive as a Utilization Care Manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

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

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What is the highest paying healthcare administration job?

In healthcare administration, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to have the highest salaries, often exceeding six figures annually. These positions require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
What are popular job titles related to Utilization Care Manager jobs in Rochester, NY? For Utilization Care Manager jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Utilization Care Manager jobs in Rochester, NY look for? The top searched job categories for Utilization Care Manager jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Utilization Care Manager jobs? Cities near Rochester, NY with the most Utilization Care Manager job openings:
Utilization Care Manager jobs near you
Care Manager

Care Manager

Rochester Rehabilitation Center

Rochester, NY • On-site

Full-time

Posted 16 days ago

Job description

Company Description
Throughout its history, three values - work, wellness, and independence - have remained at the core of Rochester Rehabilitation. Working with a $7 million annual operating budget, the agency serves 2,500 people in the Greater Rochester area living with disabilities, behavioral health issues, and other disadvantages.
Job Description
To provide patient-centered, high quality care management services in a timely manner to clients with complex chronic conditions by navigating systems such as primary medical, specialty and behavioral health care, as well as social services.
Key Functions:
  • Provides comprehensive care management services including: outreach and engagement; assessment/reassessment; development and implementation of initial and revised individualized care plans; consult with primary care physician, and other care provide(s); identify crisis intervention plan.
  • Provides care coordination and health promotion including: collaborate with service providers and health plans to obtain medically necessary care, share crisis intervention(s) and emergency info; linkage to services to support care and treatment goals/plans; patient education ; self-help recovery and selfmanagement; case reviews; advocate for services and assist with scheduling;collaborate with providers to ensure service delivery; monitor, support, accompany (as indicated) patient to/with scheduled appointments; crisis intervention .
  • Provides comprehensive transitional care including: follow up on notice of ER/hospital/residential/rehab setting admission and discharge; facilitate discharge planning with ER/hospital/residential/rehab setting staff to a safe location with care needs in place; notify service providers of admission/discharge and follow appointment needs; link with community supports; post discharge follow up.
  • Provides members and family support including: care planning with patient/family; patient/family consultation and education around health care needs; patient/family meetings; patient/family referral to peer supports, support groups, social services and other programs as indicated; collaborate with community providers to support service utilization based on patient/family need.
  • Provides referral to community and social support services including: identifying and linking to community supports as needed; assure and assist with access to medical, behavioral health, substance abuse and other community based services as needed.
  • Timely and comprehensive completion of documentation including notes, assessments, tracking tools, etc.
  • Adheres to Company policies and procedures to include being aware of the importance of Corporate Compliance Policies and the Code of Conduct. Staff is responsible for maintaining required certifications and licenses.
  • Attends necessary trainings and inservices, participates in department and agency meetings as required.
  • Performs other related duties as assigned by supervisor/director.

Qualifications
  • Bachelor's degree in any of the following: child & family studies, community mental health, counseling, education, nursing, occupational therapy, physical therapy, psychology, recreation, recreational therapy, rehabilitation, social work, sociology, or speech and hearing; OR
  • NYS licensure and current registration as a Registered Nurse and a bachelor's degree; OR
  • A Bachelor's level education or higher in any field with five years of experience working directly with persons with behavioral health diagnoses; OR
  • A Credentialed Alcoholism and Substance Abuse Counselor (CASAC).
  • Two years' experience (a Master's degree in a related field may substitute for one year's experience) either:
  • Providing direct services to persons with serious mental illness, developmental disabilities, alcohol or substance abuse; OR
  • Linking persons who have serious mental illness, developmental disabilities, alcohol or substance abuse.

Additional Information
To apply, please complete an online application at the link below:
https://www.rochesterrehab.org/jobseekers
Our Agencies do not discriminate against employees or applicants in the hiring, promotion, compensation, placement, termination, layoff, recall, transfer, leaves of absence or any other term or condition of employment on the basis of race, color, religion, sex, sexual orientation, gender identity/expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran, domestic violence victim status, prior arrest and conviction records or any other protected category in accordance with applicable federal, state and local laws.

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