REGISTERED NURSE
Rochester, NY ยท On-site
... Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients Provides education to clients on health and wellness issues.
Rochester, NY ยท On-site
... Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients Provides education to clients on health and wellness issues.
Rochester, NY ยท On-site
... Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients Provides education to clients on health and wellness issues.
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$35 - $38/hr
Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed. * Coordinates discharge planning for clients * Provides education to clients on health and ...
Rochester, NY ยท On-site
$57.50 - $69/hr
You may be required to provide clinical and distributive services including Drug Utilization Reviews (DUR), pharmacotherapy consults, anticoagulation management, health and wellness program ...
Rochester, NY ยท On-site
$57.50 - $69/hr
You may be required to provide clinical and distributive services including Drug Utilization Reviews (DUR), pharmacotherapy consults, anticoagulation management, health and wellness program ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Henrietta, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Henrietta, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
Batavia, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Batavia, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Rochester, NY ยท On-site
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Education : High School ...
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
$21 - $21.30/hr
Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings. 2. Observe all safety rules and regulations for self and others. Qualifications Education
Newark, NY ยท On-site
$62K - $66K/yr
Provides information for HMO and payer utilization review as required. * Participates in staff meetings and clinical supervision as determined by supervisor. * Inform supervisors of significant ...
Newark, NY ยท On-site
$62K - $66K/yr
Provides information for HMO and payer utilization review as required. * Participates in staff meetings and clinical supervision as determined by supervisor. * Inform supervisors of significant ...
Participates in utilization review and/or continuous quality improvement activities as requested. * Attends required staff meetings, in-services and/or supervisory conferences. * Participates in ...
Participates in utilization review and/or continuous quality improvement activities as requested. * Attends required staff meetings, in-services and/or supervisory conferences. * Participates in ...
Newark, NY ยท On-site
$62K - $66K/yr
Provides information for HMO and payer utilization review as required. * Participates in staff meetings and clinical supervision as determined by supervisor. * Inform supervisors of significant ...
Quick apply
Newark, NY ยท On-site
$62K - $66K/yr
Provides information for HMO and payer utilization review as required. * Participates in staff meetings and clinical supervision as determined by supervisor. * Inform supervisors of significant ...
$21.11 - $25.38
2% of jobs
$25.38 - $29.65
9% of jobs
$32.57 is the 25th percentile. Wages below this are outliers.
$29.65 - $33.92
21% of jobs
The median wage is $37.37 / hr.
$33.92 - $38.19
23% of jobs
$38.19 - $42.46
13% of jobs
$45.78 is the 75th percentile. Wages above this are outliers.
$42.46 - $46.72
10% of jobs
$46.72 - $50.99
8% of jobs
$50.99 - $55.26
5% of jobs
$55.26 - $59.53
5% of jobs
$59.53 - $63.80
2% of jobs
$63.80 - $68.07
2% of jobs
$21
$41
$68
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

Other
Retirement
Posted 7 days ago
Under general supervision, provides comprehensive health services and supervision for LPN and/or Medical Liaison staff if applicable. Works collaboratively with other providers to facilitate client wellness. Maintains all applicable confidentiality and ethical standards of relevant governing bodies. Effectively supports ongoing and collaborative communication amongst all program staff and is responsible for ensuring a trauma informed care environment.
Essential duties and responsibilities include:
Note: The above description is illustrative of tasks and responsibilities. It is not meant to be all inclusive. Employees are required to follow appropriate supervisory direction and perform other related duties as required.
Qualifications include:
Physical demands/work environment include:
Compliance: Adheres to all applicable federal and state laws and regulations including, but not limited to, those governing confidentiality, privacy, program, billing, and documentation standards. All duties must be performed in accordance with CCFCS's corporate compliance & ethics program. Any offer of employment will be contingent upon successful completion of a background check. CCDOR considers all background check information in accordance with applicable law.
Additional requirements include:
Top benefits and perks include:
Join us and help make a positive impact in our community! ***Catholic Charities is committed to leveraging the talent of a diverse workforce to create great opportunities for our agency and our people. EOE/AA Disability/Vet