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Utilization Management Assistant Jobs in New York

Judi Health

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 * Serves as the clinical operations liaison to assist with ad-hoc sales requests and ...

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 ...

MJHS

Managed Care Coordinator

Manhattan, NY · On-site

$38K - $48K/yr

C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide ... Familiarity with utilization management/case management

HealthCare Partners, MSO

Claims Assistant

Garden City, NY · On-site

$21 - $22.50/hr

The Claims Assistant works closely with Claims Examiners, Customer Service, Utilization Management, and Provider Services to support efficient claims operations. Essential Position Functions ...

HealthCare Partners

Claims Assistant

Garden City, NY

$21 - $22.50/hr

The Claims Assistant works closely with Claims Examiners, Customer Service, Utilization Management, and Provider Services to support efficient claims operations. Essential Position Functions ...

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Utilization Management Assistant information

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$31.7K

$52.9K

$76K

How much do utilization management assistant jobs pay per year?

As of Aug 14, 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 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 skills do you need for utilization management assistant?

A utilization management assistant needs strong organizational skills, attention to detail, and knowledge of healthcare policies and insurance procedures. Good communication skills and proficiency with electronic health records (EHR) systems are also important for coordinating patient information and supporting case reviews.

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.

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 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, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $52,947 per year, or $25.5 per hour.

Care Manager - Utilization Management (Must Have UAS Experience)

MetroPlusHealth

Manhattan, NY • Remote

$112K/yr

Full-time

Re-posted 17 days ago

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

268th of 307 rated insurance

Job description

Position Overview

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. The Care Manager, under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatient and inpatient. The Care Manager will assist the provider in directing care to the most appropriate setting, evaluating alternative care plans, and assessing outcomes through outreach to the members.

Duties & Responsibilities

• Performs care management including hospital admission certification, continued stay review, discharge planning, outpatient, and ancillary services review, etc., following established MetroPlusHealth Utilization Management policies, procedures, and protocols.

• Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members requiring care management in a cost-effective manner.

• Interacts and obtains relevant clinical information from members’ PCP and other providers; approves care that meets established criteria; and refers all other cases to the MetroPlusHealth Physician Advisor/Medical Director. Informs member and provider of Utilization Management determinations and treatment alternatives.

• Identifies utilization trends and potential member needs by means of generating reports of encounter data, pharmacy data review, and new member health assessment forms.

• Evaluate member needs for referred cases (from providers or member self-referred).

• Assists all departments with the resolution of members’ problems related to utilization management issues.

• Performs all Utilization Management activities in compliance with all regulatory agency requirements.

• Conducts medical record reviews as appropriate to case management functions.

• Participate in Medical Management grand rounds with the Physician Advisor.

• Performs all other duties as assigned

Minimum Qualifications

• New York State license as Registered Nurse, License Practical Nurse, or Physical Therapist required

• High School Diploma General Equivalency Diploma (GED) required; and

• 2-5 years’ clinical experience in an acute or applicable care setting.

• UM/UR experience in managed care or hospital setting required.

Professional Competencies

• Integrity and Trust

• Customer Focus

• Excellent communication, written and analytical skills.

• Knowledge of computer systems.

#LI-REMOTE

#MPH-50

What MetroPlusHealth employees say

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