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Utilization Review Specialist Remote Jobs in Rochester, NY

micro1 AI

Cheminformatics Specialist - Remote

Rochester, NY · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · Remote

$60 - $65/hr

While this is a remote position, candidates must reside in or be willing to relocate to one of the ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

Rochester Regional Health

Coder - Inpatient

Rochester, NY · On-site +1

$21.50 - $26/hr

SUMMARY Review clinical documentation and diagnostic results to extract data and apply appropriate ... Riedman- Remote SCHEDULE: Day shift ATTRIBUTES * Abides by the Standards of Ethical Coding as set ...

Webbing

Customer Success Manager

York, NY · On-site +1

Lead Executive Business Reviews (EBRs) and strategic planning sessions. * Track commitments and ... specialists in an international environment. * Fully remote role * Medical benefits

Deloitte

Epic Denials Management Operator

Rochester, NY · Remote

$17.75 - $23.75/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Webbing

CSM Team Lead

York, NY · On-site +1

... Reviews, anticipating customer risks, coaching team members, and serving as the voice of the ... specialists in an international environment. * Fully remote role * Medical benefits

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Utilization Review Specialist Remote information

See Rochester, NY salary details

$15

$31

$52

How much do utilization review specialist remote jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization review specialist remote in Rochester, NY is $31.51, according to ZipRecruiter salary data. Most workers in this role earn between $22.07 and $40.10 per hour, depending on experience, location, and employer.

What is a utilization review specialist?

Utilization Review Specialists (Remote) are healthcare professionals who work from home to evaluate the necessity, appropriateness, and efficiency of medical treatments and services. They review patient records, medical documentation, and insurance information to ensure healthcare services meet established guidelines and regulations. Their goal is to help manage healthcare costs while ensuring patients receive appropriate care, often acting as a liaison between healthcare providers, insurance companies, and patients.

What are the key skills and qualifications needed to thrive as a utilization review specialist?

To thrive as a Utilization Review Specialist (Remote), you need expertise in clinical guidelines, medical terminology, and case management, often backed by a nursing or healthcare-related degree and relevant licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance policies or regulatory compliance is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for this role. These skills ensure accurate case evaluations, regulatory adherence, and effective collaboration with healthcare providers and payers.

How does a utilization review specialist typically collaborate with healthcare providers and insurance companies?

As a remote Utilization Review Specialist, you’ll frequently interact with healthcare providers and insurance representatives via phone, email, and secure digital platforms. Collaboration often involves reviewing patient records, clarifying clinical details, and ensuring documentation meets payer requirements. Maintaining clear, timely communication is crucial for resolving discrepancies and facilitating care authorizations. Most organizations utilize electronic health record (EHR) systems and case management software to streamline these interactions and support remote teamwork.
What are popular job titles related to Utilization Review Specialist Remote jobs in Rochester, NY? For Utilization Review Specialist Remote jobs in Rochester, NY, the most frequently searched job titles are:
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What cities near Rochester, NY are hiring for Utilization Review Specialist Remote jobs? Cities near Rochester, NY with the most Utilization Review Specialist Remote job openings:
Utilization Review Specialist Remote jobs near you
Infographic showing various Utilization Review Specialist Remote job openings in Rochester, NY as of July 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 26% In-person, and 74% Remote job distribution, with an average salary of $65,550 per year, or $31.5 per hour.

Cheminformatics Specialist - Remote

micro1 AI

Rochester, NY • On-site, Remote

$90 - $120/hr

Part-time

Posted 10 days ago

Job description

Role Title: Computational Biology Expert


Role Type: Contractor


Location: Remote


micro1 is engaging Computational Biology Experts to contribute their advanced scientific knowledge to a dynamic customer project. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required — your domain knowledge is what matters.


Scope of Work

  1. Analyze and annotate complex biological data sets, focusing on applications relevant to medicinal chemistry.
  2. Provide feedback and domain-specific insights to improve AI models in computational biology contexts.
  3. Evaluate scientific content for accuracy, relevance, and clarity, ensuring data aligns with industry standards.
  4. Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry challenges.
  5. Collaborate asynchronously with other experts to validate findings and share perspectives on project deliverables.
  6. Contribute to the refinement of data curation methodologies and best practices in computational biology.


Preferred Qualifications

  1. Advanced degree (PhD, PharmD, or MSc) in computational biology, medicinal chemistry, bioinformatics, or a closely related field.
  2. Demonstrated expertise in medicinal chemistry, including experience with drug discovery or design.
  3. Strong analytical skills with a deep understanding of biological datasets and scientific literature.
  4. Experience applying computational methods to solve problems in chemistry or biology.
  5. Proficiency with relevant bioinformatics tools, cheminformatics platforms, or data analysis software.
  6. Excellent written communication skills to clearly explain complex scientific concepts to diverse audiences.
  7. Previous participation in cross-disciplinary or AI-driven scientific projects is a plus.

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