1

Utilization Manager Jobs in Rochester, NY (NOW HIRING)

... and utilization management, proactive patient management, care facilitation and treatment planning functions. The Clinical Care Coordinator/Care Manager coordinates care along with unit staff ...

RN Case Manager PC/FM

Rochester, NY · On-site

$37 - $45/hr

Under general direction of the Clinical Manager, the RN Care Manager's central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and ...

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 ...

The Resource Manager - Assurance Service lines operates flexibly, leaning into each of these ... Determine utilization metrics and measurements, report to the SL to hold people accountable to ...

Uses project management tools for effective personnel utilization, to track and report progress, and to ensure compliance with project implementation schedules. Reviews and approves the major ...

Showing results 21-40

Utilization Manager information

See Rochester, NY salary details

$38.5K

$89.8K

$165.3K

How much do utilization manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization manager in Rochester, NY is $89,822.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $108,100.00 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.

What are the most commonly searched types of Utilization jobs in Rochester, NY?

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

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

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

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

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

Infographic showing various Utilization Manager job openings in Rochester, NY as of August 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 84% Physical, 2% Hybrid, and 14% Remote job distribution, with an average salary of $89,822 per year, or $43.2 per hour.

$92K - $119K/yr

Full-time

Posted 18 days ago


Job description

Resources & Education Careers
  • Who We Are
  • Partner Solutions
    • Care Management
    • Health Equity
    • Health Home Care Management
    • Healthcare Analytics
    • Population Health
    • Utilization Management
    • Value-Based Contracting & Quality
  • Community Services
    • Community Programs
    • Social Care Network Navigation
    • Safe Options Support (SOS)
  • Provider Network
    • Join the IPA
    • Current IPA Members
Contact Now
Careers
My Account
Current Job Openings >> Software Engineer II
Software Engineer II
Summary
Title: Software Engineer II ID: IT025 Location: Rochester Job Type: Full-time Date Posted: 08/14/2026 Openings: 1 Department: Information Technology
Description

Ready to build software that changes how healthcare gets managed?

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 organizations across the industry rely on every day. This is a hands-on, full-lifecycle role on a small, early-stage product team: you'll move fluidly between application code, database design, deployment, and direct client support, working independently on complex features while helping set the engineering standards a growing team will build on. If you want real ownership, a broad technical surface, and the chance to shape a product's foundation rather than just maintain one, this is that opportunity.

For over 50 years, Elm & Oak Health has been a not-for-profit health care services organization focused on improving the health status of individuals and families who rely on government-sponsored health insurance. As one of the largest Care Management Agencies in our region, we've built an outstanding reputation for excellence - earned through quality care management grounded in compassion, empowerment, and teamwork. Join our team and you'll enjoy flexible work arrangements, competitive pay, superior benefits, and a supportive, inclusive culture that gives engineers room to grow and lead.


Health Systems Analyst
Grade 310
This is a full time position, working from home.
The minimum and maximum annual salary that Elm & Oak Health believes in good faith to be accurate for this position at the time of this posting are $92,695 -$119,179. In addition to your salary, Elm & Oak offers a comprehensive benefits package (all benefits are subject to eligibility requirements) and non-monetary perks. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

POSITION SUMMARY

The Software Engineer II designs, builds, and supports the organization's commercial software-as-a-service (SaaS) platform for healthcare compliance, audit, provider data, and utilization management. This is a hands-on product engineering role on a small, early-stage team: the incumbent contributes across the full development lifecycle (requirements definition, technical design, coding, testing, release, and production support) for a multi-tenant application delivered to external client organizations.

This is a broad role by design. The Software Engineer II works independently on complex features and moves between application code, database design, deployment, and client support as priorities change, while helping shape the engineering standards a growing product team will rely on. The platform is HIPAA-regulated and multi-tenant, so secure development and protection of client and member data are core accountabilities.

ESSENTIAL JOB DUTIES/FUNCTIONS

% of Time

Essential Function


35%

Design and Develop Product Features

  • Develop, enhance, and maintain C#/.NET application code, services, and web interfaces that make up the commercial product.
  • Translate product requirements, client feedback, and prospect input into technical designs and working software.
  • Build features to a commercial standard of usability, performance, and reliability appropriate for an externally sold product.
  • Design and implement functionality that operates correctly and securely across multiple client tenants with differing configurations.
  • Write clean, well-structured, and maintainable code consistent with established coding standards and architectural patterns.
  • Estimate effort for assigned work, sequence work against release commitments, and communicate progress, risks, and blockers proactively.

20%

Develop the Data Layer and Client Data Onboarding Capabilities

  • Design, write, and tune SQL Server objects including tables, views, stored procedures, and functions supporting product features and tenant data separation.
  • Implement parameterized data access layers that guard against injections and other common vulnerabilities.
  • Build and maintain import, export, and interface routines that bring client source data into the platform and deliver results back out.
  • Develop and consume APIs supporting integration with client and partner systems.
  • Validate data integrity and implement appropriate handling for null values, empty result sets, duplicate records, and error conditions.
  • Develop and maintain database migration scripts and versioning practices that allow schema changes to be deployed safely across tenants.


15%

Ensure Product Quality, Testing, and Release Readiness

  • Develop and execute unit, integration, and regression tests for assigned components.
  • Participate in peer code review, providing and receiving constructive technical feedback.
  • Support user acceptance testing by reproducing reported issues, preparing test data, and validating fixes.
  • Use source control, branching, and pull request practices consistent with team standards.
  • Prepare and execute builds and deployments to development, test, demonstration, and production environments.
  • Track and communicate defects, known limitations, and technical debt for prioritization.


10%

     Support Client Implementation, Demonstration, and Production Environments

  • Configure and maintain demonstration and evaluation environments used in sales and prospective client review.
  • Support onboarding of new client tenants, including configuration, reference data setup, and initial data loads.
  • Diagnose and resolve escalated client-reported defects and performance issues in production.
  • Perform root cause analysis and implement durable corrections rather than temporary workarounds.
  • Monitor application logs, availability, and performance indicators and escalate hosting or infrastructure issues appropriately.
  • Provide after-hours or on-call support for critical production issues as scheduled.      


10%

Protect Application Security, Privacy, and Tenant Data

  • Apply secure coding practices and follow organizational policies governing the handling of protected health information.
  • Implement and maintain authentication, role-based access control, tenant isolation, and audit logging within the application.
  • Ensure product data handling aligns with HIPAA and client contractual and regulatory requirements.
  • Prevent exposure of credentials, connection strings, and member-level data in code, logs, demonstration data, and non-production environments.
  • Participate in remediation of findings from security assessments, code scans, penetration tests, and client security reviews.
  • Complete all required compliance, privacy, and security training.


10%

Contribute to Product Direction and Engineering Practice

  • Participate in requirements and design discussions with product leadership, subject matter experts, and client stakeholders.
  • Document technical designs, data structures, configuration options, and deployment and release procedures.
  • Contribute to product release notes, administrator documentation, and support knowledge base content.
  • Recommend and help establish development standards, tooling, and automation appropriate to a growing product team.
  • Maintain accurate and current work item records in the team project tracking system.

Total must equal 100% - essential functions should be completed at least 10% of the time


OTHER FUNCTIONS AND RESPONSIBILITIES
  • Attend regularly scheduled department and intradepartmental meetings.
  • Work effectively in a small team environment while performing multiple tasks and shifting between priorities.
  • Participate in product planning, design, and release readiness discussions.
  • Work collaboratively with internal and external staff from diverse healthcare, operational, and technical backgrounds.
  • Support product demonstrations and client meetings by providing technical explanations and follow up as requested.
  • Maintain current working knowledge of relevant languages, frameworks, cloud services, and development practices.
  • Performs other duties as assigned.
MINIMUM REQUIREMENTS/LICENSES/CERTIFICATIONS
  • Bachelor's degree in Computer Science, Software Engineering, Information Systems, or related field; equivalent combination of education and experience may be considered.
  • Minimum of 2-4 years of professional software development experience building and supporting production applications.
  • Demonstrated proficiency in C# and .NET / .NET Core, including object-oriented design principles.
  • Working proficiency in Microsoft SQL Server, including T-SQL query development, stored procedures, schema design, and fundamentals of query performance tuning.
  • Experience developing web applications using ASP.NET, MVC, Web API, and standard front-end technologies (HTML, CSS, JavaScript).
  • Experience with source control, code review, branching, and release management within a structured software development lifecycle.
  • Experience deploying and troubleshooting applications in a hosted or cloud environment.
  • Demonstrated ability to work independently with limited direction, take ownership of deliverables end to end, and operate effectively where requirements and priorities are still evolving.
  • Strong troubleshooting and analytical skills, including the ability to diagnose issues reported by non-technical users.
  • Excellent written, verbal, and interpersonal communication skills, including the ability to explain technical concepts to non-technical audiences and to interact professionally with external clients.
  • Ability to handle confidential information and protected health information in accordance with HIPAA requirements.

Preferred Qualifications
  • Experience building or scaling a commercial, multi-tenant SaaS product, particularly at an early stage.
  • Experience in healthcare, managed care, Medicaid, or another regulated data environment.
  • Experience with cloud data platforms such as Snowflake, Databricks, Microsoft Fabric, or comparable data warehouse and Lakehouse technologies.
  • Familiarity with modern data pipeline and transformation tooling such as dbt, Azure Data Factory, or Spark-based processing.
  • Experience with AWS or Azure, including compute, storage, networking basics, and application hosting via IIS.
  • Experience with authentication and authorization patterns such as SSO, SAML, OAuth, or multi-factor authentication.
  • Experience with automated testing frameworks and CI/CD pipelines.
  • Familiarity with Agile or Scrum delivery practices.
  • Exposure to compliance frameworks relevant to software vendors, such as SOC 2 or HITRUST.

PHI MINIMUM NECESSARY USE: This staff position PHI access will be determined based on Minimum Necessary standards. The Minimum Necessary Grid can be found on the Human Resources and Compliance Web pages.

This job description is only a summary of the typical functions of the job, not an exhaustive or compr...