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Utilization Reviewer Jobs in Rochester, NY (NOW HIRING)

Voyage Health

Travel RN House Supervisor

Rochester, NY · On-site

$2.6K - $2.7K/wk

Position Details Specialty: RN Utilization Review Location: Rochester, New York Employment Type: Travel/Contract Pay: $2647 - $2786 per week Shift: 5x8 Flex Start Date: ASAP Contract Length: 13-week ...

Acacia Network

Program Director

Rochester, NY · On-site

$85K/yr

Perform utilization reviews, monitoring case records, ensuring compliance with all contract stipulations. * Review OASAS Website keeping updated with 820 regulations and local service bulletins.

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All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Rochester, NY

Utilization Reviewer information

See Rochester, NY salary details

$30.6K

$37.5K

$43.4K

How much do utilization reviewer jobs pay per year?

As of Sep 5, 2026, the average yearly pay for utilization reviewer in Rochester, NY is $37,486.00, according to ZipRecruiter salary data. Most workers in this role earn between $33,500.00 and $41,400.00 per year, depending on experience, location, and employer.

What does a utilization reviewer do?

A Utilization Reviewer is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.

What does a utilization reviewer do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

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

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.

How does a utilization reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How do I become a utilization review nurse?

To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can enhance job prospects, and strong knowledge of healthcare policies and documentation is essential.

Is utilization review a good job?

Utilization reviewers evaluate medical necessity and appropriateness of healthcare services, often working in healthcare or insurance settings. The role requires attention to detail, knowledge of healthcare policies, and sometimes certification, with typical schedules being standard business hours. It can offer stable employment and opportunities for advancement in healthcare administration.
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The top searched job categories for Utilization Reviewer jobs in Rochester, NY are:

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

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

Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Rochester, NY as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% In-person job distribution, with an average salary of $37,486 per year, or $18 per hour.

Travel Home Health Utilization Review

Uniti Med

Webster, NY • On-site

Contractor

Medical, Dental, Vision

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Uniti Med is seeking a travel Home Health Utilization Review for a travel job in Webster, New York.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: Therapy
  • Start Date: 09/14/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, nights
  • Employment Type: Travel

Benefits: 

  • Day 1 Insurance 
  • Cigna medical, MetLife dental and vision insurance 
  • License reimbursement for new licenses needed for each assignment 
  • Discounts with hotels and rental cars 
  • A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience 
  • Referral bonus up to $700 

About the Company: 

Finding the right role is about more than just matching skills to a job—it’s about aligning with your goals, values, and the way you want to work.

As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. From our first conversation to your first day on the job (and beyond!), we’re here to help you move forward with confidence.

Uniti Med Job ID #846252. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Home Health Aide

About Uniti Med

Uniti Med meticulously matches your talents to our open needs to ensure the ultimate travel experience. Tell us where you want to go and let our experienced staff lead the way!

Benefits
  • Referral bonus
  • Benefits start day 1
  • Employee assistance programs
Uniti Med logo

About Uniti Med

Sourced by ZipRecruiter

A great workplace is created when core values are exhibited by employees on a daily basis. At Uniti Med, our values are more than just aspirations, they are embedded in our decision-making processes and how we work with one another. We are always looking for good humans who understand this is exactly where they are supposed to be to change people’s lives for the better. If these values speak to you, Uniti is your home.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Omaha, NE, US

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