ZipRecruiter

Log In

1

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

ICONMA

Pharmacy Specialist Level 1

Newark, NY · On-site

$20.50 - $26.50/hr

... utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special ... Prefers a Bachelor's degree from an accredited college or university in Health Care Management ...

Jewish Senior Life

RN Supervisor

Rochester, NY · On-site

$80K - $95K/yr

Responsibility is centralized in three major areas: individual patient care management, management ... Determines optimal utilization of staff for the delivery of nursing services throughout the shift.

Jewish Senior Life

RN Supervisor

Rochester, NY · On-site

$80K - $95K/yr

Responsibility is centralized in three major areas: individual patient care management, management ... Determines optimal utilization of staff for the delivery of nursing services throughout the shift.

Allied Digestive Health

Procedure Scheduler

Rochester, NY · On-site

$21 - $26/hr

... utilization and minimizing wait times. The role requires close collaboration with medical staff ... Proficiency with Microsoft Office Suite and healthcare management software. * Demonstrated ability ...

previous page

Showing results 41-60

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 Aug 8, 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.

How does a utilization care manager 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 is a utilization care manager?

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.

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 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

RN - Case Manager

University of Rochester Medicine Home Care

Webster, NY • On-site

Other

Posted 10 days ago

Job description

Level 2 Registered Nurse Case Manager

Develops and revises plan of treatments and discharge plan in conjunction with patients, families, physicians, care delivery teams, and third-party payors including obtaining medical orders and approval of medical services. Completes and submits assessments, reassessments, transfers, resumptions of care, discharges, and significant changes in condition in accordance with defined time frames. Processes orders and notifies physicians of patient needs and changes in condition. Provides an environment that promotes respect for patients, their privacy, confidentiality, and property. Initiates appropriate preventive and rehabilitative strategies. Provides services requiring substantial specialized nursing skills. Consults with and educates patients, families, and other team members regarding disease processes, self-care techniques, and preventive strategies. Supervises LPN to ensure patient health, safety, and compliance with the plan of care. Directs, coordinates, evaluates, and supervises the quality of patient care services. Interacts with patients, physicians, referral sources, and others in a manner conducive to continued positive relationships. Supports care management philosophy, including collaborative customer-focused planning and case management designed to meet individual health and service needs, and promote quality and cost-effective outcomes. Ensures the completion of all appropriate clinical records needed for compliance with state and federal legislation. Maintains current knowledge of available community-based services. Demonstrates flexibility and willingness to visit patients based on need. Ensures problem resolution at the point of contact. Ensures authorization and release of information form has been signed by the patient or responsible party. Attends patient care conferences on patients assigned to care. Monitors results, progress, and takes corrective action on quality indicators, including the level of customer satisfaction with the nursing function. Understands the importance of the nursing role and its impact on patients, care providers, readmission, productivity, utilization, revenue, and expense. Pursues efforts to reduce or eliminate avoidable costs and errors. Responds to findings of various quality reviews and ensures resolution of potential problem areas. Participates in peer review and quality assessment and performance improvement as assigned. Maintains productivity requirements. Ensures that appropriate visit authorizations are in place and that visit documentation reflects the medical necessity for care in the home setting. Promotes a work environment of professional growth, learning, trust, and mutual respect. Participates in education including orientation and in-service training programs as needed. Demonstrates commitment to professional growth and competency. Responsible for the key performance indicators established by the manager. Performs other duties as requested.

Apply