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Utilization Management Assistant Jobs in New York

Capital Rx

Formulary Operations Pharmacist

Manhattan, NY · On-site

$64.25 - $77.25/hr

... utilization management edits * Provides clinical support to operational teams and clients during implementations * Servesas the clinical operations liaison to assist with ad-hoc sales requests and ...

Orison Solutions

RN - Utilization Review

New York, NY

$65 - $70/hr

Collaborate with Case Management, Quality Management, Medical Directors, and insurance companies ... * Assist with authorization requests, denials, appeals, and reconsiderations when applicable.

New

Orison

RN - Utilization Review

Elmhurst, NY · On-site

Collaborate with Case Management, Quality Management, Medical Directors, and insurance companies ... * Assist with authorization requests, denials, appeals, and reconsiderations when applicable.

New

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All JobsUtilization Management JobsUtilization Management Assistant JobsUtilization Management Assistant Jobs in New York

Utilization Management Assistant information

See New York salary details

$31.7K

$52.9K

$76K

How much do utilization management assistant jobs pay per year?

As of Sep 4, 2026, the average yearly pay for utilization management assistant in New York is $52,947.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,900.00 and $53,100.00 per year, depending on experience, location, and employer.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

Is utilization management assistant a good job?

Utilization Management Assistants support healthcare organizations by reviewing medical records and authorizations to ensure appropriate care and cost management. The role typically requires attention to detail, knowledge of healthcare policies, and proficiency with electronic health records systems. It can offer stable employment with opportunities for advancement in healthcare administration.

What are the most commonly searched types of Utilization Management jobs in New York?

The most popular types of Utilization Management jobs in New York are:

What cities in New York are hiring for Utilization Management Assistant jobs?

Cities in New York with the most Utilization Management Assistant job openings:

Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in New York as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 84% Physical, 2% Hybrid, and 14% Remote job distribution, with an average salary of $52,947 per year, or $25.5 per hour.

Clinical Appeals and Medical Necessity Manager (JR229392)

Montefiore

Yonkers, NY • On-site

Full-time

Re-posted 4 days ago

Job description

IntroductionTo heal, to teach, to discover and to advance the health of the communities we serve.

To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here. 

OverviewThis position directly manages the appeals process at the Wakefield Division of Montefiore Medical Center. This RN/PA/FMG/MD/HIM Professional responds to third party clinical denials, interfaces with health plans, works closely with Finance and Contracting regarding utilization management health plan issues, and advises the Director of denial trends.

Responsibilities

  • S/he analyzes Wakefield Division denials and acts accordingly to minimize the financial impact of third-party payer denials.
  • S/he ensures the Wakefield Division denials and appeals are documented properly in the designated automated tracking application.
  • S/he performs first-level review for FFS Medicare elective and emergent hospital admissions.
  • S/he also acts as a resource regarding medical necessity to other associates of the department and to departments that interface with Utilization Management.
  • S/he exhibits expertise in the knowledge of rules, mandates and regulations related to denials and appeals and educates and mentors Case Managers/CTCC's and related staff to ensure compliance with these.
  • S/he will interface with the Case Managers/CTCC's in order to clarify clinical scenarios when medical record documentation is insufficient to do so and the Case Manager/CTCC's was involved with a case on a concurrent basis.
  • CTCC's performing appeals activity report to this associate.

Requirements

  • Bachelor's degree in health care or related field required - Master's preferred.
  • RN/Physician Assistant/Foreign Medical Graduate/HIM Professional preferred.
  • Analytical skills required.
  • Knowledge of Medical Terminology required.
  • Experience in Managed Care/Utilization Management required.
  • Excellent verbal and written communication and interpersonal skills required.
  • Excellent organizational skills required.

Apply