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Utilization Review Jobs in Rochester, NY (NOW HIRING)

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

Residential Assistant

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

Residential Assistant

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

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 ...

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 ...

Residential Assistant

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

Residential Assistant

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 ...

Residential Assistant

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

Residential Assistant

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

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 ...

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

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

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Utilization Review information

See Rochester, NY salary details

$21

$41

$68

How much do utilization review jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for utilization review 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 jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

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.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

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.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

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.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
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 jobs? Cities near Rochester, NY with the most Utilization Review job openings:
Infographic showing various Utilization Review job openings in Rochester, NY as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.
REGISTERED NURSE

Other

Retirement

Posted 7 days ago


Job description

Registered Nurse

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:

  • Provides a comprehensive health assessment of clients.
  • Identifies immediate and long-term health care needs.
  • Makes appropriate referrals and recommendations based on findings of the health assessments.
  • Assists clients in identifying local resources.
  • Communicates and collaborates with appropriate Agency staff, Primary Health care provider, community justice agencies, and related community organizations to assure coordination of client care and services.
  • Completes required paperwork related to the health assessment process.
  • Provide oversight and supervision of any assigned LPN and/or Medical Liaison Staff: Required supervision of tasks performed by LPN and/or Medical Liaison staff may include medication monitoring or administration, monitoring of vital signs, reporting of signs or symptoms of potential health concerns, basic emergency medical treatment or interventions.
  • Direct, coach, collaborate with and delegate tasks appropriately.
  • Build and sustains cooperative working relationships among program staff.
  • Assist in the initiation and implementation of staff development and training programs to maximize professional practice.
  • Accesses employees' skills and program needs and appropriately assign staff to meet program needs.
  • Participates in selection, hiring, and orientation of Staff.
  • Coordinates employee schedules to ensure day-to-day coverage of the Programs.
  • Reviews and approves timesheets.
  • Evaluates program effectiveness and recommends alternatives as required.
  • Assists Prescribers Provide health monitoring for clients Administers Injectable medications as prescribed
  • Responsible for case load records Completes required case record documentation in accordance with regulations and other record keeping as necessary for program accountability 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 wellness issues.
  • Participates in staff meetings and clinical supervision as directed Actively pursues development of professional competencies related to job role performance through reading, supervision, in-service training and attendance at conferences and workshops.
  • Awareness and active support of the Agency's Mission, Vision, Values and Strategic Plan. Including, but not limited to, supporting the Agency's Core Competency initiatives of being Collaborative and Community Focused, Innovative and Entrepreneurial, and Culturally Competent and Diverse

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:

  • Education: Minimum of an Associate's Degree in Nursing required. Bachelor's or Master's Degree in Nursing preferred.
  • Credentials: Valid and clean NYS Driver's License. Valid Registered Professional Nurse (RN) License required
  • Experience: At least two years of experience related to nursing services to individuals with mental health, chemical dependency, substance use disorder, or intellectual/developmental disabilities-related services strongly preferred. Bi-lingual in Spanish also preferred.

Physical demands/work environment include:

  • The physical demands/work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, stand, walk, use hands to type and/or perform light lifting. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The noise level in the work environment is usually quiet.

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:

  • Ability to prioritize assignments, plan, and complete work projects with minimal direction,
  • An ability to work efficiently and effectively and meet deadlines,
  • An ability to work under pressure,
  • Excellent verbal/written skills,
  • Ability to maintain confidentiality,
  • Ability to demonstrate behaviors and attitudes which support agency mission, philosophy, and policies.
  • Willingness and ability to foster agency and program wide cooperation and teamwork through use of positive/constructive communication techniques,
  • Possession of a valid NYS Driver's license and use of a registered and reliable vehicle.

Top benefits and perks include:

  • Competitive salary and 403b retirement plan
  • Generous time off package and work-life balance
  • Comprehensive benefits package
  • Supportive and collaborative environment
  • Opportunities for growth and development
  • Intrinsic reward of truly making a difference in people's lives

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