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Utilization Coordinator Jobs in Rochester, NY (NOW HIRING)

Pharmacy Specialist Level 1

Newark, NY ยท On-site

$20.50 - $26.50/hr

... coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in ...

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 ...

Showing results 21-40

Utilization Coordinator information

See Rochester, NY salary details

$15

$28

$58

How much do utilization coordinator jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization coordinator in Rochester, NY is $28.59, according to ZipRecruiter salary data. Most workers in this role earn between $20.14 and $32.36 per hour, depending on experience, location, and employer.

How does a utilization coordinator typically interact with clinical and administrative teams in a healthcare setting?

A Utilization Coordinator regularly collaborates with both clinical teams, such as physicians and nurses, and administrative staff to ensure that patient care services are medically necessary and efficiently delivered. They review medical records, coordinate pre-authorizations, and communicate with insurance providers to support appropriate resource use. Effective communication and teamwork are essential, as Utilization Coordinators often serve as a liaison between departments, helping to resolve discrepancies and streamline processes for optimal patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization coordinator, and why are they important?

To thrive as a Utilization Coordinator, you need a background in healthcare or social services, strong analytical skills, and familiarity with medical terminology, often supported by a relevant degree or certification. Proficiency in case management software, electronic health records (EHRs), and knowledge of insurance policies and regulatory requirements is typically required. Excellent communication, organizational, and problem-solving abilities help you effectively coordinate care and advocate for patient needs. These skills ensure efficient resource utilization, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What is the difference between Utilization Coordinator vs Utilization Review Specialist?

AspectUtilization CoordinatorUtilization Review Specialist
CredentialsTypically requires healthcare-related certifications or licenses, such as a Registered Nurse (RN) or healthcare administration backgroundOften requires similar healthcare credentials, including RN, licensed practical nurse (LPN), or medical reviewer certifications
Work EnvironmentWorks in hospitals, clinics, or insurance companies, coordinating patient services and resource allocationWorks mainly in insurance companies or healthcare facilities, reviewing medical necessity and treatment plans
Employer & Industry UsageCommonly employed by healthcare providers and insurance companies to optimize resource usePrimarily employed by insurance companies and third-party payers for case reviews

While both roles involve healthcare coordination and require similar credentials, the Utilization Coordinator focuses on managing patient services and resource allocation, whereas the Utilization Review Specialist primarily reviews medical necessity and treatment plans for approval or denial.

What degree do I need for utilization review?

Utilization coordinators typically need at least a bachelor's degree in healthcare administration, nursing, or a related field. Relevant certifications, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and data management tools is also important.

What is a utilization coordinator?

Utilization Coordinators are healthcare professionals responsible for reviewing and monitoring the use of medical services to ensure patients receive appropriate care efficiently and cost-effectively. They assess treatment plans, review medical records, and help coordinate care among providers to ensure compliance with insurance and regulatory guidelines. Utilization Coordinators also work with clinical staff to determine the medical necessity of procedures and help optimize patient outcomes while managing healthcare costs.
What are the most commonly searched types of Utilization jobs in Rochester, NY? The most popular types of Utilization jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Utilization Coordinator jobs? Cities near Rochester, NY with the most Utilization Coordinator job openings:
Infographic showing various Utilization Coordinator job openings in Rochester, NY as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 83% Physical, 1% Hybrid, and 16% Remote job distribution, with an average salary of $56,683 per year, or $27.3 per hour.

Community Habilitation Coordinator

Ibero-American Action League, Inc.

Rochester, NY โ€ข On-site

Full-time

Re-posted 22 days ago


Job description

Description:

Summary

The Community Habilitation Coordinator is responsible for coordinating, monitoring, and supporting services that help individuals with intellectual and developmental disabilities develop skills for independence and community integration. The coordinator ensures services are person-centered, compliant with OPWDD regulations, and aligned with each individual’s Life Plan.


Essential Functions:

Reasonable Accommodations Statement: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

  • Reports directly to the HCBS Supervisor.
  • Establishes and maintains good working relationships with other staff from other service delivery agencies as well as staff from other IBERO programs.
  • Monitor service delivery to ensure goals and outcomes are being addressed.
  • Assures all procedures are implemented as required by Federal, State, Agency and Program regulations, policies, and procedures.
  • Meets monthly with immediate supervisor to report any issues or concerns, review the past weeks and plans for the following month.
  • Attend formal and informal training sessions in/outside the agency.
  • Research and link clients with appropriate services.
  • Complete a written individualized service plan for each participant and update every six months
  • Submit reports on activities and related duties monthly to Director
  • Develops individual’s progress towards goals as included in the individual service plan.
  • Provides advocacy and support services to individuals and their families as needed.
  • Responsible for scheduling and supervising Community Habilitation staff.
  • Complete individual satisfaction survey to receive feedback on services rendered.
  • Ensure staff are trained and follow service plans and documentation requirements.
  • Address staff performance concerns promptly and professionally.
  • Ability to work with individuals with different cultural backgrounds.
  • Complete and update written documentation monthly.
  • Is available to work outside of regular scheduled work hours as needed.
  • Monitor service quality and ensure compliance with health and safety standards.
  • Conduct field visits and observations of staff providing services.
  • Identify areas for improvement and implement corrective actions.
  • Assist with staff scheduling and coverage as needed.
  • Track service utilization and ensuring authorized hours are met.
  • Any other duties assigned by supervisor.

Authority:

This position holds a relatively high degree of independence within the framework of the agency's policies and procedures. The individual must be resourceful and able to display initiative and understanding of management systems and interpersonal relations. Must keep immediate supervisor abreast of issues and concerns which could constitute intervention from higher level management.

Requirements:

Position Qualifications:

Competency Statement(s)

  • Associate's in Human Services or related field preferred and or a minimum of 3 years’ experience working with OPWDD regulations and policies.
  • Bilingual English/Spanish
  • Must possess a valid NYS driver's license and meet Ibero's Vehicle Operator Requirements.
  • Knowledge of OPWDD regulations and person-centered planning.
  • Strong organizational, communication, and leadership skills.
  • Ability to work independently and collaboratively.
  • A combination of training and experience other than the specified, if judged to be adequate for the job, may be accepted by the President and CEO.


Skills and Abilities:

  • Support a person's unique capacities, personality and potential
  • Getting to know a person through assessment/discovery
  • Promoting advocacy with the individual
  • Facilitating personal growth and development
  • Facilitation of support and services
  • Building and maintaining relationships
  • Creating meaningful communication
  • Develop professional relationships
  • Exhibit professional behavior
  • Show respect for diversity and inclusion
  • Create meaningful documentation reports
  • Education, training and self-development activities
  • Organizational participation
  • Exhibit ethical behavior on the job
  • Promote positive behavior and support
  • Supports health and wellness
  • Prevents, recognizes and reports abuse
  • Supports crisis prevention, intervention and resolution
  • Supports safety
  • Ensures safety of individuals during environmental emergencies
  • Supports people to live in the home of their choice
  • Supports active participation in the community
  • Supports employment, education and career goal attainment

Physical Demands:


The position does require occasional standing, squatting, lifting of up to approximately 30 lbs. And frequent sitting.


Ibero American Action League is committed to the policy of equal employment opportunity. This policy expressly prohibits discrimination on the basis of sex, race, color, religion, creed, national origin, age, marital status, sexual orientation, disability, gender identity or expression, genetic predisposition or carrier status, domestic violence victim status, veteran status or status as a member of any other protected group or activity.

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By signing below, I hereby acknowledge receipt of my job description. I am aware that continued employment with Ibero-American Action League, Inc. is contingent on my adherence to the policies outlined in the employee handbook and my ability to function within the parameters of the job description. Furthermore, I acknowledge that any questions regarding this job description will be brought to the attention of my immediate supervisor.




Employee Signature: ________________________ Date: ________________________


The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate.



An Equal Opportunity/Affirmative Action/Pro Disabled & Veteran Employer.


Revised 3-25-2026