Quality Review & Utilization Specialist

Rochester Regional Health; City of Rochester (NY); On-site; USD 76,000 - 101,000; Full time

Job summary

Rochester Regional Health seeks a Quality Review & Utilization Specialist to join the Home Care team in Rochester, NY. The role requires a BS (Bachelor of Science) and relevant licensure to support clinical review and utilization planning. This is a full-time, daytime position with standard Monday–Friday hours.

Candidates must hold BLS, a NYS driver’s license, and an RN credential where applicable. The role emphasizes accuracy, documentation, and collaboration across care teams within Rochester

Qualifications

• BS is required for this role.
• Licenses: BLS (AHA), NYS Driver's License, RN license as applicable.

Education

BS

Job description

Job Title: Quality Review & Utilization SpecialistDEPARTMENT: Quality ReviewLOCATION: Home Care-330 Monroe Ave, Rochester, NYHOURS: Per Week: 40 HoursSCHEDULE: 8:30am-5:00pm Monday-FridayEDUCATION:BS (Required)LICENSES / CERTIFICATIONS:BLS - Basic Life Support - American Heart Association (AHA), NYS DL - valid New York State Driver's License - New York State Department of Motor Vehicles (NYSDMV), RN - Registered Nurse - NYS Office of ProfessionsPHYSICAL REQUIREMENTS:Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver’s license.For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.PAY RANGE:$75,700.00 - $101,000.00CITY:RochesterPOSTAL CODE:14607The posted pay range is a good faith representation of potential base pay for this position. It may be modified in the future and eligible for additional pay components. Individual annual salaries/hourly rates could vary based on position details and FTE. Pay is determined by considering factors including, but not limited to, experience, relevant qualifications, specialty, internal equity, locations, and contracts.Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.