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Utilization Review Director Jobs in Rochester, NY

HRI Hospitality

Director of Sales & Marketing

Hilton, NY · On-site

$98K - $162K/yr

... Review presentations * Support all direct sales efforts to include sales trips, off property ... utilization of resources * Work with Corporate Marketing Manager in taking an active role in ...

DePaul

Residential Assistant

Rochester, NY · On-site

$21 - $21.30/hr

DIRECT SERVICE RESPONSIBILITIES: * Provide teaching, supervision, and support to residents in areas ... Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other ...

DePaul

Residential Assistant

Batavia, NY

$21 - $21.30/hr

DIRECT SERVICE RESPONSIBILITIES: * Provide teaching, supervision, and support to residents in areas ... Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other ...

DePaul

Residential Assistant

Rochester, NY · On-site

$21 - $21.30/hr

DIRECT SERVICE RESPONSIBILITIES: * Provide teaching, supervision, and support to residents in areas ... Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other ...

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Utilization Review Director information

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How much do utilization review director jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for utilization review director in Rochester, NY is $41.74, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What is the difference between Utilization Review Director vs Utilization Review Nurse?

AspectUtilization Review DirectorUtilization Review Nurse
CredentialsRN license, management experience, certifications (e.g., CCM)RN license, certification in case management or utilization review (e.g., CUC)
Work EnvironmentAdministrative, leadership roles overseeing teamsClinical, review of patient cases, direct patient care
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Search & Comparison IntentLeadership, management, strategic planning in utilization reviewClinical review, case assessment, patient care coordination

The Utilization Review Director typically oversees review teams and manages utilization strategies, requiring leadership skills and management experience. In contrast, the Utilization Review Nurse focuses on clinical case assessments and patient care reviews. Both roles require RN licensure and relevant certifications but differ mainly in scope and responsibilities.

What does a utilization review director do?

A Utilization Review Director oversees the evaluation of medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead teams that review patient care requests, manage compliance with regulations, and implement strategies to ensure cost-effective care without compromising quality. Their responsibilities often include policy development, data analysis, and collaboration with healthcare providers to optimize resource use and improve patient outcomes.

Is utilization review a stressful job?

Utilization Review Directors often work in high-pressure environments where they must make quick, accurate decisions regarding healthcare services. The role can be stressful due to the need to balance patient care, insurance policies, and regulatory compliance, but stress levels vary based on workload, organizational support, and experience. Strong analytical skills and certification in utilization review can help manage job demands effectively.

What degree do I need for utilization review director?

A utilization review director typically needs at least a bachelor's degree in healthcare administration, nursing, or a related field. Many employers prefer candidates with a master's degree such as an MBA or a healthcare-related advanced degree, along with relevant experience and certifications like the Certified Professional in Healthcare Quality (CPHQ).

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

A Utilization Review Director often navigates challenges such as balancing regulatory compliance with organizational goals, managing interdisciplinary teams, and keeping up with evolving healthcare policies. Staying proactive with ongoing education, fostering open communication among staff, and implementing efficient review processes can help address these issues. Additionally, leveraging data analytics and technology streamlines case reviews and ensures evidence-based decision-making, ultimately improving both patient outcomes and operational efficiency.

What are the key skills and qualifications needed to thrive as a utilization review director, and why are they important?

To thrive as a Utilization Review Director, you need a deep understanding of clinical guidelines, healthcare regulations, and case management principles, typically supported by a nursing or related healthcare degree and relevant licensure. Familiarity with utilization management software, electronic health records (EHR), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) is common in the field. Strong leadership, communication, analytical thinking, and decision-making skills help you effectively manage teams and ensure compliance. These competencies ensure efficient resource use, regulatory adherence, and high-quality patient outcomes within healthcare organizations.
What are the most commonly searched types of Utilization Review jobs in Rochester, NY? The most popular types of Utilization Review jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Utilization Review Director jobs? Cities near Rochester, NY with the most Utilization Review Director job openings:
Utilization Review Director jobs near you

RRC Assistant Director

Volunteers of America Upstate NY

Rochester, NY

$63K - $65K/yr

Full-time

Posted 3 days ago

New

Volunteers Of America rating

6.9

Company rating: 6.9 out of 10

Based on 127 frontline employees who took The Breakroom Quiz

387th of 771 rated non-profit organizations

Job description

Position Title:  Residential Re-Entry Center Assistant Director

Classification: Exempt/ Full-Time  Salary Range: $63,000 - $65,000

Reports to:      Residential Re-Entry Center Director

Location:         Rochester, NY

HOURS:  Approximately 3 p.m. to 11:00 p.m. with flexibility based on RRC needs and activities.

____________________________________________________________________________________                                                                                                             

SUMMARY

The Residential Re-entry Center (RRC) is a transitional housing program that provides assistance to federal inmates who are nearing release. The RRC, under contract with the Federal Bureau of Prisons (BOP), provides a safe, structured, supervised environment, as well as employment counseling, job placement, financial management assistance, and other programs and services designed to assist residents to rebuild their ties to the community and facilitate their re-entry to the community.

The Assistant Director is responsible for the oversight of all aspects of the RRC program to ensure compliance with all Volunteers of America, American Corrections Association (ACA), and Bureau of Prisons (BOP) standards. 

PRIMARY RESPONSIBILITIES

  • Assist in managing the operations of the RRC including its home confinement component in accordance with agency, ACA, BOP, PREA, and any other applicable standards. 
  • Work in partnership with the Director to ensure all procedures adhere to agency, ACA, BOP, and PREA standards and assist in the provision of training for staff.
  • Assist the Director in providing supervision to the PSO Manager and the and public safety officers.
  • Provide oversight of the Electronic Monitoring of RRC participants on Ankle Monitoring, including those participants on home confinement and weekend passes.
  • Work with the PSO Manager and PSO staff to oversee the collection of random urine screens of all the RRC Participants, including completing a Monthly Urine Sampling Report of all samples taken.
  • Provide oversight of the monthly search of the Re Entry Center as well the monthly searches of RRC participants' cars who are authorized to drive.
  • Collaborate with the VOA maintenance, food service, and administrative departments to ensure that all necessary resources are available and in compliance with all agency, ACA and BOP standards.
  • Utilize strengths-based programming and tools (i.e.; LSI-Rs).
  • Assist the Director to ensure that Center Disciplinary Hearings are held in a timely manner and in accordance with BOP standards.
  • Help to ensure maximum utilization of all facility bed space and home confinement resources.
  • Assist the Director in the coordination of the quarterly meetings of the Community          Re-Entry Advisory Board (CRAB).
  • Assist with the regular reviews of case files
  • Conduct regular monitoring to ensure adherence to PREA regulations.
  • Ensure adequate training and refresher training of staff.
  • Ensure adequate PSO staff coverage at the RRC.
  • Assist with tracking outcomes and completing reports in an accurate and timely manner.
  • Play a lead role in ensuring the safety and security of the residents, staff, and facility.
  • Assist with on-call.
  • Other duties as required.

QUALIFICATIONS & REQUIREMENTS   

  • Bachelor’s degree in social/behavioral science or criminal justice degree. Master’s preferred;
  • Two years of work experience in a related field [i.e.; Correctional Management] and a minimum of two years experience in supervision are required;
  • OR equivalent combination of education and experience and a minimum of two years experience in supervision required.
  • Excellent organizational and Communication skills are a must.
  • Clean NYS Driver’s License.
  • Proficient in MS Office Suite

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