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Utilization Manager Jobs in Schenectady, NY (NOW HIRING)

Evolent

Field Medical Director, Vascular Surgeon

Albany, NY · On-site

$130 - $140/hr

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

Evolent

Field Medical Director, Cardiology

Albany, NY · On-site

$165.31 - $185.98/hr

What You'll Be Doing As a Cardiology, Field Medical Director you will be a key member of the utilization management team. This role offers a meaningful way to make a difference in patients' lives in ...

Marquis Home Care

Authorizations Specialist

Albany, NY · On-site

$20 - $25/hr

Communicate with insurance companies, MLTCs, Managed Care plans, Medicare Advantage, and other payors to ensure timely approvals. * Track authorization statuses, expirations, and visit utilization to ...

Albanymed

Transitional Care Case Manager

Albany, NY · On-site

$94K - $147K/yr

Recent experience in case management, utilization management and/or discharge planning/home care in a high volume, acute care hospital - preferred * Ability to multi-task with all roles assigned to ...

Albanymed

Transitional Care Case Manager

Albany, NY · On-site

$94K - $147K/yr

Recent experience in case management, utilization management and/or discharge planning/home care in a high volume, acute care hospital - preferred * Demonstrates effective communication, facilitation ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Schenectady, NY

Utilization Manager information

See Schenectady, NY salary details

$37.7K

$88.1K

$162.1K

How much do utilization manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization manager in Schenectady, NY is $88,056.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,600.00 and $105,900.00 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 popular job titles related to Utilization Manager jobs in Schenectady, NY?

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

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Schenectady, NY as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $88,056 per year, or $42.3 per hour.

Care Management Representative

Saratoga Hospital

Saratoga Springs, NY • On-site

$33.60 - $56.50/hr

Per diem

Medical, Dental, Retirement

Re-posted 21 days ago

Saratoga Hospital rating

7.3

Company rating: 7.3 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

345th of 1,064 rated hospitals

Job description

Care Management Representative
Location: Saratoga Hospital, 211 Church Street, Saratoga Springs, NY 12866
Shift/Schedule: Day Shift
Department: Care Management
Salary Range: $38.00-$60.00
About Saratoga Hospital
At Saratoga Hospital, we've built a reputation for high-quality, compassionate care and a commitment to the health and well-being of our community. As part of the Albany Med Health System, we combine advanced technology with a deeply personal approach-creating a supportive environment for patients, staff, and providers alike. We believe that exceptional care starts with exceptional people.
About the Role
This nursing position is responsible for providing care coordination, comprehensive discharge planning, daily rounding with an interdisciplinary team, utilization review/management, readmission avoidance action plan strategies, care transitions coordination and strategic plans for the Collaborative Practice Groups under the guidance of the Director of Care Management. The Care Management Representative participates in a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services for a patient's individual health needs under the Scope of Service for the department. Provides linkages, referrals, coordination, and follow-up for identified patients and those who qualify for Health Homes. Coordinates follow-up appointments with the patient's Primary Care Physician /Patient Center Medical Home/ Health Home based on risk status.
What You'll Do
  • Assesses patients within service line to identify needs according to established guidelines & Care Management policies. Coordinates care, monitors patient progress daily, and establishes discharge goals based on the care plan and patient outcomes with input from the interdisciplinary team. Completes CM assessments and LACE tool readmission risk determinations for identified patients such as those with chronic diseases (CHF, RF, COPD, MI, PN & DM as well as those previously re-admitted or identified at-risk patients).
  • Participates in daily rounds with physicians and team. Develops discharge goals based on patient progress and anticipated LOS targets. Works to minimize discharge delays and achieve appropriate discharge times.
  • Documents the care plan and goals in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness & intensity of service for appropriate utilization management and 1st level criteria reviews. Documents required data in Allscripts and follow the Care Management Plan Policy for utilization review & management. Follows through with the attending physician regarding patient status and level of care. As needed, consult internal and external physician advisor for 2nd level reviews.
  • Initiates community resource referrals as needed based on patient choice and post-hospitalization needs for discharge and transfer. Coordinates interdisciplinary collaboration to achieve patient safety and a safe discharge plan. Maintains a working knowledge of the resources available in the community and requirements of government payers and managed care organizations. Provides appropriate linkages, referral coordination, and follow-up for identified patients and those requiring Health Homes and other transitions.
  • Advocates for the patient's and family's needs. Arranges patient care conferences as needed to facilitate complex discharge planning, improve communications, and achieve quality patient outcomes.
  • Participates in the goals and activities of the Collaborative Practice Groups, Magnet Councils, Interdisciplinary Committees and/or Utilization Management Committee. Develops and implements interdisciplinary care plans as needed for service lines and improved patient outcomes. Takes an active role in committee membership, agenda planning, case study presentations and committee reports.
  • Serves as a resource to physicians, patients/families regarding insurance coverage/reimbursement. Adheres to established guidelines for working with insurance case managers and utilization specialists. Monitors daily insurance logs for accuracy and appropriate patient status. Appropriately identifies patient's level of care and collaborates with physician regarding status changes to ALC (Alternate Level of Care), skilled & custodial care for Medicare patients. Completes HINN notices and documentation requirements for Medicare regulations as required. Issues "Important Medicare Message" (IM) as required 24-48 hours prior to discharges of Medicare and/or Management Medicare patients.

What You Bring
  • BSN preferred (or matriculating towards degree achievement)
  • Minimum of 3 years acute care hospital experience
  • Knowledgeable of New York State and Federal Entitlement Programs and regulatory requirements
  • Certifications / Licensure
  • Current NYS RN nursing license
  • PRI Certification preferred
  • CCM Certification preferred

Why Saratoga Hospital
  • A caring, community-focused culture rooted in teamwork and trust
  • Supportive leadership that invests in your development and well-being
  • Comprehensive benefits, including medical, dental, retirement plans, tuition assistance, and wellness programs. Click here to view our complete benefits guide.
  • Opportunities to grow within the Albany Med Health System
  • Located in beautiful Saratoga Springs, known for its vibrant community, outdoor recreation, and cultural attractions

Our Commitment
We are an equal opportunity employer and strongly encourage individuals of all backgrounds and experiences to apply. If you're passionate about healthcare and community service-even if you don't meet every qualification listed-we'd still love to hear from you.
How to Apply
Click the 'apply' button to submit your resume and complete our online application. Applications are reviewed on a rolling basis-apply today and discover what makes Saratoga Hospital a special place to grow your career.

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