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Utilization Manager Jobs in New York (NOW HIRING)

Medix

Director of Utilization Management

Manhattan, NY · On-site

$109.15 - $151.44/hr

Responsible for oversight of utilization management services and resources through case reviews, peer reviews, and appeals. * Document all case reviews utilizing the care management system.

CareConnect

Utilization Review RN

Greenvale, NY · On-site

Provides timely and thorough case screening to identify case management needs and make appropriate ... Responds to outstanding utilization management issues and inquiries made via overnight voicemail ...

CareConnect

Utilization Review RN

Greenvale, NY · On-site

Provides timely and thorough case screening to identify case management needs and make appropriate ... Responds to outstanding utilization management issues and inquiries made via overnight voicemail ...

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Showing results 41-60

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in New York

Utilization Manager information

See New York salary details

$42.7K

$99.6K

$183.3K

How much do utilization manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization manager in New York is $99,569.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,100.00 and $119,800.00 per year, depending on experience, location, and employer.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

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

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs

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

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

What are popular job titles related to Utilization Manager jobs in New York?

For Utilization Manager jobs in New York, the most frequently searched job titles are:

What job categories do people searching Utilization Manager jobs in New York look for?

The top searched job categories for Utilization Manager jobs in New York are:

What cities in New York are hiring for Utilization Manager jobs?

Cities in New York with the most Utilization Manager job openings:

What are popular job titles related to Utilization Manager jobs in NY?

For Utilization Manager jobs in NY, the most frequently searched job titles are:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in New York as of August 2026, with employment types broken down into 86% Full Time, 13% Part Time, and 1% Contract. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $99,569 per year, or $47.9 per hour.

Care Manager - Utilization Management (Must Have UAS Experience)

MetroPlusHealth

Manhattan, NY • Remote

$112K/yr

Full-time

Re-posted 6 days ago

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

275th of 315 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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