Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site +1
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
Rochester, NY · On-site +1
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
Rochester, NY · On-site +1
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
Rochester, NY · On-site +1
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
Rochester, NY · On-site
$92K - $119K/yr
Join Elm & Oak Health as a Software Engineer II and help build our commercial SaaS platform from the ground up - the compliance, audit, provider data, and utilization management tools that client ...
New
Rochester, NY · On-site
$92K - $119K/yr
Join Elm & Oak Health as a Software Engineer II and help build our commercial SaaS platform from the ground up - the compliance, audit, provider data, and utilization management tools that client ...
New
$105K - $115K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Responsible for clinical care, bed utilization and fiscal management which includes all tasks performed by Revenue Cycle Management, the Utilization Case Manager, and all other responsible parties.
New
$105K - $115K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Responsible for clinical care, bed utilization and fiscal management which includes all tasks performed by Revenue Cycle Management, the Utilization Case Manager, and all other responsible parties.
New
Rochester, NY · On-site
$105K - $115K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Responsible for clinical care, bed utilization and fiscal management which includes all tasks performed by Revenue Cycle Management, the Utilization Case Manager, and all other responsible parties.
New
Rochester, NY · On-site
$105K - $115K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Responsible for clinical care, bed utilization and fiscal management which includes all tasks performed by Revenue Cycle Management, the Utilization Case Manager, and all other responsible parties.
New
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Rochester, NY · On-site
$77K - $93K/yr
... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...
Victor, NY · On-site
$29 - $37/hr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$29 - $37/hr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$62K - $85K/yr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$62K - $85K/yr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$29 - $37/hr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$29 - $37/hr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$62K - $85K/yr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Victor, NY · On-site
$62K - $85K/yr
Interact with insurance companies for pre-certification and utilization management * Participating in discharge and aftercare planning * Therapeutic meal support, while modeling a healthy ...
Rochester, NY · On-site
$116K - $139K/yr
Utilization Management (UM) Focus: The clinical pharmacist position is responsible for and participates in a wide range of provider, patient, employer initiatives and programs. The pharmacist ...
Rochester, NY · On-site
$116K - $139K/yr
Utilization Management (UM) Focus: The clinical pharmacist position is responsible for and participates in a wide range of provider, patient, employer initiatives and programs. The pharmacist ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site
$37 - $45/hr
... utilization management, proactive patient management, care facilitation and treatment planning functions. The RN Care Manager manages clinical aspects of patient centered medical home, working with ...
Rochester, NY · On-site
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
Rochester, NY · On-site
$20.99 - $28.34/hr
... notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case ...
$38.5K - $49.6K
15% of jobs
$49.6K - $60.7K
8% of jobs
$62.3K is the 25th percentile. Wages below this are outliers.
$60.7K - $71.8K
15% of jobs
The median wage is $78.9K / yr.
$71.8K - $83K
20% of jobs
$83K - $94.1K
11% of jobs
$99.6K is the 75th percentile. Wages above this are outliers.
$94.1K - $105.2K
13% of jobs
$105.2K - $116.3K
5% of jobs
$116.3K - $127.4K
3% of jobs
$127.4K - $138.6K
4% of jobs
$138.6K - $149.7K
3% of jobs
$149.7K - $160.8K
3% of jobs
$38.5K
$88.3K
$160.8K
A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.
As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.
The most popular types of Utilization Management jobs in Rochester, NY are:
For Utilization Management jobs in Rochester, NY, the most frequently searched job titles are:
The top searched job categories for Utilization Management jobs in Rochester, NY are:
Cities near Rochester, NY with the most Utilization Management job openings:
$77K - $93K/yr
Full-time, Part-time
Re-posted 9 days ago
8.3
Based on 186 frontline employees who took The Breakroom Quiz
126th of 618 rated colleges and universities
Highland Hospital is seeking a full time Case Manager to join the team. Hours will be Monday-Friday from 8am-4:30pm.
Under general direction, the Clinical Care Coordinator/Case Manager's role is to coordinate interdisciplinary care planning to achieve timely and safe discharge and/or to coordinate access and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff (Nursing, Providers, Consulting Services, Social Work) and providers caring for the patient at discharge to assist in facilitating a patient focused plan of care aimed at ensuring a safe transition from hospital to home for adult acute care patients.
Essential functions include, but are not limited to:
Get the full story on Breakroom
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Colleges, universities, and professional schools
10,000+ Employees
Rochester, NY, US
1850
