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Utilization Review Manager Jobs in Rochester, NY

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · Remote

... management of assigned therapists when necessary * Perform ongoing review of high-risk cases and provide clinical solutions as appropriate * Engage in the Utilization Review process for assigned ...

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · On-site

$65K - $120K/yr

... management of assigned therapists when necessary * Perform ongoing review of high-risk cases and provide clinical solutions as appropriate * Engage in the Utilization Review process for assigned ...

DePaul

Rehabilitation & Standards Manager

Rochester, NY · On-site

$25 - $26.20/hr

Oversee systems to ensure staff provide case management / rehabilitation services to residents ... Give relevant input for treatment team meetings, staff meetings, utilization reviews and any other ...

DePaul

Rehabilitation & Standards Manager

Rochester, NY · On-site

$25 - $26.20/hr

Oversee systems to ensure staff provide case management / rehabilitation services to residents ... Give relevant input for treatment team meetings, staff meetings, utilization reviews and any other ...

DePaul

Rehabilitation & Standards Manager

Rochester, NY

$25 - $26.20/hr

Oversee systems to ensure staff provide case management / rehabilitation services to residents ... Give relevant input for treatment team meetings, staff meetings, utilization reviews and any other ...

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All JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Rochester, NY

Utilization Review Manager information

See Rochester, NY salary details

$38.5K

$89.8K

$165.3K

How much do utilization review manager jobs pay per year?

As of Jun 21, 2026, the average yearly pay for utilization review manager in Rochester, NY is $89,798.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $108,000.00 per year, depending on experience, location, and employer.

What jobs pay $2000 a day?

Utilization Review Managers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly paid medical professionals. Most jobs with daily earnings of this level require extensive experience, certifications, or work in high-demand industries like finance, law, or executive management.

What are some common challenges faced by Utilization Review Managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What job makes $10,000 a month without a degree?

A Utilization Review Manager can potentially earn around $10,000 per month, especially with extensive experience and certifications in healthcare management or medical review. These roles typically require strong analytical skills, knowledge of medical billing and coding, and the ability to oversee utilization review processes in healthcare settings. While a degree can be helpful, some professionals advance through experience and industry certifications such as Certified Professional in Healthcare Quality (CPHQ).

What are the key skills and qualifications needed to thrive as a Utilization Review Manager, and why are they important?

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What jobs in the US pay 300,000 a year?

Utilization Review Managers in healthcare or insurance industries can earn around $300,000 annually with extensive experience, advanced certifications, and leadership responsibilities. High-paying roles often require strong analytical skills, knowledge of medical billing and coding, and proficiency with healthcare management software. Executive-level positions in healthcare organizations may also reach or exceed this salary level.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A utilization review manager oversees the process of evaluating medical services to ensure they are necessary, appropriate, and cost-effective. They coordinate with healthcare providers, review patient records, and ensure compliance with insurance and regulatory standards, often using specialized software. This role requires strong analytical skills and knowledge of healthcare policies and insurance guidelines.
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 are popular job titles related to Utilization Review Manager jobs in Rochester, NY? For Utilization Review Manager jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Rochester, NY look for? The top searched job categories for Utilization Review Manager jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Utilization Review Manager jobs? Cities near Rochester, NY with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Community Health Worker

Community Health Worker

Dayton Children's Hospital

Pavilion, NY

$18 - $23.50/hr

Full-time

Posted 24 days ago

Dayton Children's Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 45 frontline employees who took The Breakroom Quiz

522nd of 1,001 rated hospitals

Job description

Facility:Child Health PavilionDepartment:Community Mental Health ServicesSchedule:Full timeHours:40Job Details:As part of the Integrated Care Department, the Community Health Worker (CHW) is a part of a multidisciplinary team comprised of Medical Social Workers, Nurse Care Managers, Utilization Review nurses, and Resource Specialists, serving as a liaison and an extension of care between the healthcare system, social services, and the community. The CHWs serves as a trusted support to the patients and families in the Dayton region by building relationships, facilitating access to services, and improving the quality and cultural competence of service delivery.
A Community Health Worker also builds individual and community resiliency by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, social support, and advocacy. This education may be identified by the specialized area of care or focus of chronic condition the patient and/or family exhibits including, but not limited to asthma management, sickle cell disease management, infant and maternal health improved outcomes, high risk pregnancy and postpartum support, and foster care/kinship needs. CHWs help to break down barriers that a family may have that prevents them from attending appointments, following medication regimens, maintaining routines, schedules, and safe health habits. CHWs help families set goals and empower them to advocate for themselves and their children. CHWs also provide community education and engagement through the participation of various community outreach activities and events. CHWs further support families through facilitation of enrollment in the Dayton Regional Pathways HUB and other value-based opportunities with Medicaid Managed Care entities.
Education
Associates degree from an accredited program is required
Certification
Community Health Worker certification which is licensed by Ohio Board of Nursing, including CPR certification obtained within 12 months of hire.
Experience
Good driving record and reliable transportation required
Experience with computer software including Microsoft Word and Excel required
A working knowledge of community resources is required.
Good communication skills are required
1-2 yr. working in Healthcare or Public Health systems preferred
Knowledge of some medical terminology is preferred

Department Specific Job Details:

  • full time, 40 hours
  • Monday - Friday, 8:00 AM - 4:30 PM
  • serving the Community Health services at the Connor Child Health Pavilion

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