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Utilization Manager Jobs in New Rochelle, NY (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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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in New Rochelle, NY

Utilization Manager information

See New Rochelle, NY salary details

$40.1K

$93.7K

$172.4K

How much do utilization manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization manager in New Rochelle, NY is $93,656.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,200.00 and $112,700.00 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 Rochelle, NY?

The most popular types of Utilization jobs in New Rochelle, NY are:

What job categories do people searching Utilization Manager jobs in New Rochelle, NY look for?

The top searched job categories for Utilization Manager jobs in New Rochelle, NY are:

What cities near New Rochelle, NY are hiring for Utilization Manager jobs?

Cities near New Rochelle, NY with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in New Rochelle, NY as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $93,656 per year, or $45 per hour.

Director of Utilization Management

Medix

Manhattan, NY • On-site

$109.15 - $151.44/hr

Full-time

Medical, Dental, Vision, Retirement

Posted 26 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a skilled Director of Utilization Management to oversee the delivery of utilization management services, including case reviews, peer reviews, and appeals. The successful candidate will ensure compliance with regulatory requirements, participate in audits and reviews, and contribute to the development and attainment of annual goals.
Key Responsibilities
  • 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.
  • Participate in case rounds and ICT meetings to develop UM/CM plans for patient continuity of care.
  • Analyze utilization patterns, trends, and implement strategies to align with expected benchmarks.
  • Ensure compliance with regulatory and contractual requirements for Medical Management functions.
  • Participate in State and Federal Regulatory audits, investigations, surveys, and reviews.
  • Maintain current knowledge of Federal and State regulatory requirements.
  • Develop and propose annual goals, providing regular progress reports.

Qualifications
  • Medical Doctorate is required.
  • Current and unrestricted Physician license to practice in New York.
  • Preferred: Board Certification in internal medicine, emergency medicine, or family medicine.
  • Preferred: Master's Degree in public health.

Experience
  • 3-5 years of health plan experience in medical management, particularly with Medicare and Medicaid Programs.
  • Experience with both inpatient and outpatient utilization management, including medical and pharmacy utilization.
  • Experience with appeal reviews.
  • NY Market Experience.

Skills
  • Strong ability to analyze utilization patterns and implement strategies for benchmark alignment.
  • Effective communication skills for participation in audits, reviews, and cross-departmental collaboration.

Additional Requirements
  • M-F 9-5 Work Schedule.

Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
* As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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