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Utilization Management Associate Jobs in New York

MJHS

Managed Care Coordinator

Manhattan, NY · On-site

$38K - $48K/yr

Medical Associates, P.C. Status: Regular Full-Time Office: Hybrid Salary: $38,545.53 - $48,181.92 ... Familiarity with utilization management/case management

ING Group

Associate, Portfolio Analytics

New York, NY · On-site

$110K - $135K/yr

Lending | Portfolio Management | Associate, Portfolio Analytics | New York About ING : In the ... Management team * Monitoring clients' performance, utilization of limits, portfolio churn ...

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Utilization Management Associate information

What does a utilization management associate do?

A Utilization Management Associate is responsible for reviewing healthcare services and determining whether they are medically necessary, appropriate, and efficient. They work with healthcare providers, insurance companies, and patients to ensure that treatments comply with established guidelines and policies. Their role often includes reviewing medical records, processing authorizations, and assisting in the coordination of care to optimize the use of healthcare resources. This position helps control costs while ensuring that patients receive the appropriate level of care.

What skills and qualifications are needed to thrive as a utilization management associate?

A Utilization Management Associate typically needs a background in healthcare administration or a related field, strong analytical skills, and knowledge of medical terminology and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and regulatory compliance systems is important, and certifications like Certified Professional in Healthcare Management (CPHM) can be advantageous. Attention to detail, effective communication, and strong organizational skills help associates excel in evaluating medical necessity and collaborating with care teams. These competencies ensure accurate, efficient review processes that support quality patient care and compliance with payer requirements.

What are the typical daily responsibilities of a utilization management associate?

Utilization Management Associates typically review medical records, verify insurance coverage, and coordinate with healthcare providers to ensure that treatments and services meet established guidelines and payer requirements. They also communicate with physicians and patients to gather necessary information for authorization requests. By ensuring appropriate utilization of healthcare resources, they help support patient care while managing costs and compliance for their organization. Collaboration with clinical staff and insurance representatives is a key part of the role, contributing to effective case management.

What is the difference between Utilization Management Associate vs Utilization Review Coordinator?

AspectUtilization Management AssociateUtilization Review Coordinator
CertificationsTypically requires a healthcare-related certification or licenseOften requires similar certifications, such as CCM or RHIA
Work EnvironmentWorks in insurance companies, healthcare providers, or managed care organizationsWorks in hospitals, insurance companies, or healthcare facilities
Job FocusAssists in reviewing medical necessity and authorization processesCoordinates and conducts utilization reviews and approvals
Common UsageUsed interchangeably in healthcare and insurance settingsOften used in hospital and insurance contexts

The Utilization Management Associate and Utilization Review Coordinator roles share similarities in certifications and work environments, focusing on reviewing medical necessity and authorization. The main difference lies in their specific responsibilities, with associates assisting in the process and coordinators actively conducting reviews and approvals.

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 Associate jobs?

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

Infographic showing various Utilization Management Associate 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.

Managed Care Coordinator

Manhattan, NY • On-site

Metropolitan Jewish Health System
Hospitals • 1 - 5K employees
Learn more about Metropolitan Jewish Health Systemexternal

$38K - $48K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 19 days ago

MJHS Health System rating

7.9

Company rating: 7.9 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

Job description

Overview

Rooted in Jewish values and traditions, and consistent with the highest standards of quality care, MJHS Health System is a premier provider of health services in the greater metropolitan area and beyond, ensuring access to health, supportive and community-based services across the continuum of need.  Our MJHS Medical Associates, P.C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as well as to those living at home.

The MJHS Difference

At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Benefits include:

  • Tuition Reimbursement for all full and part-time staff
  • Generous paid time off, including your birthday!
  • Affordable and comprehensive medical, dental and vision coverage for employee and family members
  • Two retirement plans! 403(b) AND Employer Paid Pension
  • Flexible spending
  • And MORE!

MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)

Responsibilities

Our MJHS Medical Associates, P.C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as well as to those living at home.

Ensure high quality, cost-effective care and services for Elderplan members through support of professionalCare Management and/or Clinical Service activities. This position supports all aspects of care coordination forour ISNP, IESNP and Elderplan Plus members in compliance with all departmental and regulatory requirements.The position requires excellent communication and organizational skills.

Qualifications
  • High School Diploma or equivalent; College Degree preferred

  • One-year prior managed care experience preferred

  • Prior experience in a health care setting preferred

  • Familiarity with utilization management/case management

MinUSD $38,545.53/Yr.MaxUSD $48,181.92/Yr.Employment Type: FULL_TIME

What MJHS Health System employees say

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