1

Utilization Review Salary Jobs in Rochester, NY (NOW HIRING)

This role reviews in-progress and completed work for completeness, quality, and adherence to ... Uses project management tools for effective personnel utilization, to track and report progress ...

Lead, Government Compliance

Rochester, NY

$87K - $196K/yr

  • Medical

  • Retirement

  • PTO

Complete government Purchase Order compliance reviews to support maintaining an approved purchasing ... Evaluate Request for Proposal (RFP) requirements for Small Business utilization and participation.

Salary: $87,800 - $116,300 annually + up to 6% bonus Shift: Monday - Friday, 6:00 AM - 4:00 PM ... utilization, and predictive maintenance programs. * Maintain equipment records, SAP Bills of ...

RN Care Coordinator

Rochester, NY · On-site

$77K - $93K/yr

... utilization management, proactive patient management, care facilitation and treatment planning ... Complete the Patient Review Instrument * Other duties as assigned Salary Range: $77,220.15- $93,600 ...

RN Care Coordinator

Rochester, NY · On-site

$77K - $93K/yr

... utilization management, proactive patient management, care facilitation and treatment planning ... Complete the Patient Review Instrument * Other duties as assigned Salary Range: $77,220.15- $93,600 ...

Showing results 21-40

Utilization Review Salary information

See Rochester, NY salary details

$21

$41

$68

How much do utilization review salary jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization review salary in Rochester, NY is $41.72, 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 are some common challenges utilization review professionals face in balancing patient advocacy with cost management?

Utilization Review professionals often navigate the delicate balance between ensuring patients receive appropriate care and managing healthcare costs for providers and insurers. One common challenge is interpreting complex medical records to make fair, evidence-based decisions while also adhering to strict guidelines and insurance policies. Additionally, communicating denial decisions to providers or patients requires tact and empathy. Staying current with constantly evolving regulations and medical standards is also essential to perform the role effectively.

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

To thrive as a Utilization Review Nurse, you need a valid RN license, clinical experience, and strong knowledge of medical coding and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically required. Excellent analytical thinking, attention to detail, and effective communication skills help professionals excel in this role. These capabilities are crucial for making accurate coverage decisions, ensuring compliance, and facilitating high-quality, cost-effective patient care.

What is the average salary for a utilization review nurse?

The average salary for a Utilization Review Nurse in the United States typically ranges from $65,000 to $85,000 per year, depending on factors such as experience, education, location, and employer. Major metropolitan areas and hospitals may offer higher compensation, while remote or rural locations might pay less. In addition to base salary, some positions may offer benefits like health insurance, retirement plans, and bonuses. It's important to research the specific employer and geographic region for the most accurate salary information.

What is the difference between Utilization Review Salary vs Case Manager Salary?

AspectUtilization Review SalaryCase Manager Salary
Required CredentialsRN, LPN, or other healthcare certificationsRN, social work, or healthcare-related certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Employer & Industry UsageUsed mainly in insurance and healthcare review settingsUsed across healthcare, social services, and insurance sectors

Utilization Review Salary and Case Manager Salary share similar credentials and work environments, often within healthcare and insurance industries. While utilization review focuses on evaluating medical necessity and appropriateness of care, case managers coordinate patient care and support. Both roles require healthcare or social work certifications, but their primary functions differ, with utilization review emphasizing review processes and case management emphasizing patient advocacy and coordination.

What degree do I need for utilization review?

Utilization review professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Many employers prefer candidates with a background in nursing or healthcare management, and some roles may require licensure or certification such as the Certified Professional in Healthcare Quality (CPHQ).

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

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

Infographic showing various Utilization Review Salary job openings in Rochester, NY as of June 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

Manager, Data Platforms Admin

Lthc

Rochester, NY

Full-time

Medical, Dental, Retirement

Posted 26 days ago


Job description

Job Description:

Summary:

The Manager of Data Platform Administration plans, directs, and evaluates the work of Data Platform Administration team in the planning, design, development and maintenance of new and existing applications and data systems. This position communicates with users to develop and maintain a firsthand knowledge of their plans, operations, problems, and opportunities. This position also champions the development, enforcement and refinement of standards for use, control, performance, updating and maintenance in conjunction with Data Platform Administration. This role reviews in-progress and completed work for completeness, quality, and adherence to standards.

The Manager role is a highly technical position that focuses on Data Analytic platforms such as: Databricks, IBM Cognos, Power BI, SAS. The role will work with and provide guidance for a cross-functional team of technical professionals.

Essential Accountabilities:

Plans, directs and controls the activities of the analysis, design, development, and installation phases of the systems lifecycle.

Reviews service requests / projects and consults with executive sponsors, requesters, and/or user representatives to clarify intent, discuss problematic areas, and consider alternate solutions.

Estimates staffing requirements, costs and time for project activities, and assigns systems resources. 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 deliverables of the systems development methodology and ensures that all required walk-throughs have been conducted with the appropriate users.

Communications with data center management for resolution of system problem situations, and on proper, efficient, and cost-effective utilization of EDP resources.

Assists the IS Planning Manager in developing the corporate information systems model, identifying those systems that will require development, and establishing a development sequence.

Confers with and advises subordinates on administrative policies and procedures, technical problems, priorities and methods.

Interviews, selects, trains and mentors Data Platform Administration professionals.

Ensures effective availability and utilization of material resources by planning, budgeting and maintaining operational costs within corporate guidelines.

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.

Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are compliant with these requirements.

Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.

Regular and reliable attendance is expected and required.

Performs other functions as assigned by management.

Minimum Qualifications:

Seven (7) years related work experience.

Bachelor's degree in computer science, Information Technology or relevant field. In lieu of a degree, six (6) years of experience required.

Advanced expertise in database design, development, testing and maintenance for production ready systems.

Advanced expertise in structured systems analysis and design, user relations, data gathering techniques, and management information systems.

Prior experience supervising or managing people and/or projects or indirectly leading teams.

Demonstrated analytical, diagnostic, and problem-solving abilities.

Expertise in project planning and project management.

Ability to effectively communication, across all levels within the organization.

Physical Requirements:

Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.

Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

************

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Min - 110,093 Max - 198,168

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: The opportunity for remote work may be possible for all jobs posted by the Univera Healthcare Talent Acquisition team. This decision is made on a case-by-case basis.


All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.