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Utilization Management Jobs in Rochester, NY (NOW HIRING)

Ensure studies reflect implementation realities including throughput, staffing, quality systems, and utilization management. Scientific & Commercial Impact * Collaborate with Medical Affairs to ...

Oracle PMO - Manager

Rochester, NY ยท On-site

$99K - $232K/yr

... utilization of business applications. As a Manager, you will enhance your leadership style by motivating, developing, and inspiring others to deliver quality. You are responsible for coaching ...

Overview The Quality Management Specialist works with the Quality Management Department to provide ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

Quality Management Specialist I

Rochester, NY ยท On-site

$23.20 - $24.70/hr

The Quality Management Specialist works with the Quality Management Department to provide the ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

Quality Management Specialist I

Rochester, NY ยท On-site

$23.20 - $24.70/hr

Overview The Quality Management Specialist works with the Quality Management Department to provide ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

Overview The Quality Management Specialist works with the Quality Management Department to provide ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

The Quality Management Specialist works with the Quality Management Department to provide the ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

Overview The Quality Management Specialist works with the Quality Management Department to provide ... Responsible for Utilization Record Review functions to include Individual record audits, admission ...

... of talent management, retention, operations/scheduling of resources, software ownership and ... Determine utilization metrics and measurements, report to the SL to hold people accountable to ...

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Showing results 1-20

Utilization Management information

See Rochester, NY salary details

$37.5K

$86K

$156.7K

How much do utilization management jobs pay per year?

As of Jul 7, 2026, the average yearly pay for utilization management in Rochester, NY is $86,048.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,000.00 and $100,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

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.

What is a Utilization Management job?

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.

What are the typical daily responsibilities of a Utilization Management professional?

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.

What are the most commonly searched types of Utilization Management jobs in Rochester, NY? The most popular types of Utilization Management jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Utilization Management jobs? Cities near Rochester, NY with the most Utilization Management job openings:
Infographic showing various Utilization Management job openings in Rochester, NY as of July 2026, with employment types broken down into 94% Full Time, 3% Part Time, and 3% Contract. Highlights an 97% In-person, and 3% Remote job distribution, with an average salary of $86,048 per year, or $41.4 per hour.

VP Clinical Affairs

Micro Typing Systems

Rochester, NY โ€ข On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago


Job description

The Opportunity

QuidelOrtho unites the strengths of Quidel Corporation and Ortho Clinical Diagnostics, creating a world-leading in vitro diagnostics company with award-winning expertise in immunoassay and molecular testing, clinical chemistry and transfusion medicine. We are more than 6,000 strong and do business in over 130 countries, providing answers with fast, accurate and consistent testing where and when they are needed most - home to hospital, lab to clinic.

Our culture puts our team members first and prioritizes actions that support happiness, inspiration and engagement. We strive to build meaningful connections with each other as we believe that employee happiness and business success are linked. Join us in our mission to transform the power of diagnostics into a healthier future for all.

The Role

At QuidelOrtho, we're advancing the power of diagnostics for a healthier future for all.

We are seeking an accomplished and visionary Vice President of Clinical Affairs to lead the global clinical strategy and operations department for a rapidly growing diagnostics company focused on infectious disease, cardiology, and clinical laboratory innovation. This is a high-impact executive opportunity for a leader who has helped scale and commercialize successful IVD platforms and who is ready to shape the next generation of diagnostics.

The Vice President of Clinical Affairs will lead all Clinical Strategy and Clinical Operations across the enterprise. They will be responsible for evidence generation and study execution across the company's infectious disease, cardiology, clinical laboratory portfolio, including molecular diagnostics, immunoassays, biomarkers, rapid testing, and point-of-care platforms.

The ideal candidate will bring experience from a leading diagnostics organization and have a track record of creating and executing clinical evidence programs that resulted in regulatory approvals, market adoption, and commercial success. This role offers the chance to build strategy, influence enterprise direction, lead a high-performing organization, and bring meaningful diagnostic innovations to clinicians, laboratories, and patients worldwide.

Location: This role may be performed remotely, with a preference for candidates located near our offices in San Diego, CA; Raritan, NJ; or Rochester, NY.

The Responsibilities:

Strategic Leadership

  • Develop and execute the global clinical affairs strategy aligned to pipeline and growth objectives.
  • Build integrated evidence-generation plans supporting FDA, IVDR, CE Mark, and international submissions.
  • Serve as a trusted executive advisor on clinical trends, competitive dynamics, and market opportunities.
  • Translate unmet customer needs from health systems, laboratories, and clinicians into actionable clinical priorities.

Clinical Program Leadership

  • Lead multicenter pivotal trials, performance studies, usability studies, and post-market evidence programs.
  • Ensure high-quality execution across timelines, budgets, CRO management, and investigator relationships.
  • Interpret clinical data to support claims development, product positioning, and launch readiness.

Infectious Disease & Cardiology Focus

  • Advance programs in respiratory disease, sepsis, bloodstream infection, antimicrobial stewardship, and emerging pathogens.
  • Lead evidence strategies for troponin, BNP/NT-proBNP, coagulation, and cardiovascular risk diagnostics.
  • Support clinical utility claims demonstrating workflow improvement, faster treatment decisions, and improved patient outcomes.

Clinical Laboratory Partnership

  • Drive adoption strategies informed by real-world clinical laboratory operations and customer workflow needs.
  • Build relationships with hospital labs, integrated delivery networks, academic centers, and reference laboratories.
  • Ensure studies reflect implementation realities including throughput, staffing, quality systems, and utilization management.

Scientific & Commercial Impact

  • Collaborate with Medical Affairs to develop and implement publication strategy, advisory boards, and KOL engagement.
  • Support market access and reimbursement evidence needs.
  • Partner with Commercial teams on evidence-based messaging and customer education.

Team Leadership

  • Recruit, mentor, and retain top clinical affairs talent.
  • Build scalable processes, metrics, and organizational capability to support growth.
  • Foster a culture of urgency, accountability, collaboration, and excellence.
  • Perform other work-related duties as assigned.

The Individual

  • PhD preferred with 10-15+ years of progressive leadership experience in Clinical Affairs, Medical Affairs, or Clinical Research within IVD or medical diagnostics.
  • Significant leadership experience within a top-tier diagnostics organization.
  • Demonstrated success leading studies supporting major product launches and regulatory approvals.
  • Experience across infectious disease, immunoassay, molecular diagnostics, cardiology, and/or core laboratory platforms.
  • Proven people leadership with experience managing global teams and external partners.
  • Deep understanding of FDA, IVDR, CLIA, CAP, GCP, and global diagnostics pathways.
  • Strong knowledge of clinical laboratory operations, workflow optimization, quality systems, accreditation, and customer implementation challenges.
  • Expertise in assay performance metrics, biomarker validation, and clinical utility evidence generation.
  • Strong executive presence with ability to influence board-level and enterprise stakeholders.
  • Commercial mindset with ability to connect clinical evidence to growth outcomes.
  • Entrepreneurial leader who thrives in a fast-paced, high-accountability environment.
  • Travel up to 30-40% visiting QO's design centers and supporting clinical trials
  • This position is not currently eligible for visa sponsorship.

The Key Working Relationships

Internal Partners:

  • R&D, Regulatory Affairs, Quality, Medical Affairs, Market Access, and Commercial teams to accelerate product development and successful global launches

External Partners:

  • Vendors and suppliers

How We Work

At QuidelOrtho, our culture is shaped by four core behaviors that guide how we collaborate, make decisions, and support each other and those we serve. The ideal candidate will exhibit these behaviors, as we believe they're essential to how we thrive as a team and achieve meaningful impact:

  • Thrive Together - Collaborate intentionally, grow as a team
  • Make It Happen - Focus on priorities, embrace continuous improvement
  • Commit to Service - Cultivate a service mindset
  • Embrace Inclusion - Be open and authentic, welcome diverse perspectives

The Work Environment

If the work environment is mainly typically in the lab/warehouse/production line, use verbiage like:

The work environment characteristics are representative of a manufacturing, laboratory, or warehouse environment and include handling of viral and bacterial hazards, potentially hazardous chemicals, as well as infectious or potentially infectious bodily fluids, tissues, and samples. Up to 75% of the time at desk, standing or sitting extended periods of time. Flexible work hours to meet project deadlines. Travel includes airplane, automobile travel and overnight hotel; up to 30-40% domestically.

Physical Demands

No strenuous physical activity required. Occasional light lifting of materials may be needed. Substantial time will be spent in virtual or in-person meetings, engaging with customers, and working on scientific content and documentation.

Salary Transparency

The salary range for this position takes into account a wide range of factors including education, experience, knowledge, skills, geography, and abilities of the candidate, in addition to internal equity and alignment with market data. At QuidelOrtho, it is not typical for an individual to be hired at or near the top range for their role and compensation decisions are dependent on the facts and circumstances of each case. The salary range for this position is $300,000 to $350,000 and is bonus, equity / long-term incentive eligible. QuidelOrtho offers a comprehensive benefits package including medical, dental, vision, life, and disability insurance, along with a 401(k) plan, employee assistance program, Employee Stock Purchase Plan, paid time off (including sick time), and paid Holidays. All benefits are non-contractual, and QuidelOrtho may amend, terminate, or enhance the benefits provided, as it deems appropriate.

Equal Opportunity

QuidelOrtho believes in Equal Opportunity for all and is committed to ensuring all individuals, including individuals with disabilities, have an opportunity to apply for those positions that they are interested in and qualify for without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identity, age, veteran status, disability, genetic information, or any other protected characteristic. QuidelOrtho is also committed to providing reasonable accommodations to qualified individuals so that an individual can perform the duties. If you are interested in applying for an employment opportunity and require special assistance or an accommodation to apply due to a disability, please contact us at recruiting@quidelortho.com.

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