ZipRecruiter

Log In

1

Authorization Utilization Review Jobs in Raleigh, NC

RETAIL

Part Time Pharmacy Intern P2-#394

Durham, NC · On-site

$16.25 - $20/hr

Notify the pharmacist in the event of early fills or drug utilization review (DUR) messages. Ensure ... An Intern may receive telephone refill authorizations from the prescriber or designee. 11. Assist ...

RETAIL

Part Time Pharmacy Intern P2-#394

Durham, NC · On-site

$16.25 - $20/hr

Notify the pharmacist in the event of early fills or drug utilization review (DUR) messages. Ensure ... An Intern may receive telephone refill authorizations from the prescriber or designee. 11. Assist ...

Harris Teeter

Part Time Pharmacy Intern P2

Fuquay Varina, NC · On-site

$13.75 - $17.25/hr

Notify the pharmacist in the event of earlyfills or drug utilization review (DUR) messages. Ensure ... refill authorizations toprescribers' offices. An Intern may receive telephone refill ...

Harris Teeter

Part Time Pharmacy Intern P2

Durham, NC · On-site

$16.25 - $20/hr

Notify the pharmacist in the event of earlyfills or drug utilization review (DUR) messages. Ensure ... refill authorizations toprescribers' offices. An Intern may receive telephone refill ...

Harris Teeter

Part Time Pharmacy Intern P2-#394

Durham, NC · On-site

$16.25 - $20/hr

Notify the pharmacist in the event of earlyfills or drug utilization review (DUR) messages. Ensure ... refill authorizations toprescribers' offices. An Intern may receive telephone refill ...

VGroup Inc

Integration Specialist

Raleigh, NC · On-site

Clinical policies and Prior Authorizations. * Drug Utilization Review (DUR) and pharmacy lock-in related processes * Behavioral health, and A+ kids. * Preferred Drug List (PDL) and Medicaid Drug ...

Team Select Home Care

Case Manager

Raleigh, NC

$19.50 - $25/hr

... their authorized representative, the agency and other healthcare providers/facilities/ outside ... Participates in clinical record/utilization review of medical records and quality assurance and ...

Team Select Home Care

Case Manager

Raleigh, NC · On-site

$19.50 - $25/hr

... their authorized representative, the agency and other healthcare providers/facilities/ outside ... Participates in clinical record/utilization review of medical records and quality assurance and ...

Deloitte

Medical Reviews RN

Raleigh, NC

... review of medical records to flag findings of potential quality of care and/or utilization issues ... Must be legally authorized to work in the United States without the need for employer sponsorship ...

Community Based Care

IDD Qualified Professional

Cary, NC · On-site

$16.50 - $20.50/hr

Review and train staff on person specific competencies * Scheduling authorized services for service ... Monitor utilization to ensure authorized units meet the person's needs. ADVOCACY SUPPORT * Maintain ...

Samprasoft

SWET-Software Engineer in Test 4

Durham, NC · On-site

Build Medical / Care Management platform, providing market-leading solution for Utilization Mgmt., Prior Authorization, Case & Disease Management and Concurrent Review. Top Requirements: * Cypress

next page

Showing results 1-20

All JobsAuthorization Utilization Review JobsAuthorization Utilization Review Jobs in Raleigh, NC

Authorization Utilization Review information

See Raleigh, NC salary details

$20

$41

$67

How much do authorization utilization review jobs pay per hour?

As of Jun 27, 2026, the average hourly pay for authorization utilization review in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Authorization Utilization Review Specialist, and why are they important?

To thrive as an Authorization Utilization Review Specialist, you need a solid understanding of medical terminology, healthcare regulations, and insurance policies, often backed by a clinical background or relevant certifications. Familiarity with utilization management software, electronic health records (EHR), and payer portals is typically required. Strong attention to detail, analytical thinking, and effective communication are vital soft skills for coordinating with providers and payers. These skills ensure accurate authorization decisions, regulatory compliance, and efficient patient care coordination.

What are some common challenges faced by professionals in Authorization Utilization Review roles, and how can they be addressed?

Professionals in Authorization Utilization Review often encounter challenges such as managing high caseloads, navigating complex insurance guidelines, and ensuring timely communication with providers and patients. Staying organized and up-to-date with evolving payer requirements is essential to avoid delays or denials. Building strong collaboration with clinical teams and leveraging electronic health record systems can help streamline workflows and improve efficiency in the review process.

What is the difference between Authorization Utilization Review vs Claims Reviewer?

AspectAuthorization Utilization ReviewClaims Reviewer
CredentialsTypically requires healthcare or insurance-related certifications, such as RN, CPC, or licensed healthcare professionalsOften requires similar credentials, focusing on insurance policies and claims processing
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, third-party administrators, healthcare organizations
Industry UsageUsed to assess medical necessity before approving servicesUsed to evaluate claims for payment accuracy and compliance

Authorization Utilization Review and Claims Reviewer roles both involve insurance and healthcare knowledge, but Authorization Utilization Review focuses on pre-authorization of services, while Claims Review centers on post-service claims assessment. Understanding these differences helps clarify career paths and job expectations in healthcare insurance.

What is Authorization Utilization Review?

Authorization Utilization Review is a process used by healthcare organizations and insurance companies to assess the medical necessity and appropriateness of medical services before they are provided. The main goal is to ensure that patients receive care that is effective, efficient, and covered by their health plan. This review typically involves evaluating patient records, treatment plans, and provider requests to decide if the requested services meet established guidelines. By doing so, it helps control healthcare costs and ensures quality care for patients.
What are popular job titles related to Authorization Utilization Review jobs in Raleigh, NC? For Authorization Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Authorization Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Authorization Utilization Review jobs in Raleigh, NC are:
Authorization Utilization Review jobs near you
Part Time Pharmacy Graduate-Chapel Hill/Releigh Market Intern

Part Time Pharmacy Graduate-Chapel Hill/Releigh Market Intern

RETAIL

Chapel Hill, NC • On-site

$14.25 - $17.75/hr

Other

Posted yesterday

Harris Teeter rating

6.3

Company rating: 6.3 out of 10

Based on 847 frontline employees who took The Breakroom Quiz

43rd of 118 rated grocery stores

Job description

Responsible for providing customer service and assisting the Pharmacists in dispensing prescriptions, entering information into computer, ordering and receiving product, checking in orders, stocking, record keeping, answering telephone calls, and maintaining the overall conditions of the Pharmacy Department as defined in the Pharmacy Standards Manual.

ESSENTIAL JOB FUNCTIONS:

1. Comply with all State and Federal regulations, which require that all dispensing activities occur under the direct supervision of a licensed pharmacist.

2. Greet customers and receive prescriptions. If an existing patient, request birth date. Obtain new patient information by requesting a patient/representative fill out a patient history form, including address, VIC number, phone number, birth date, drug allergies, disease states, and whether the patient wishes to receive medications in non-childproof containers.

3. Provide the Harris Teeter "Notice of Privacy Practices" and acknowledgement form to each new patient/representative. Monitor patient signing for HIPAA at register on signature pad.

4. Determine whether the patient wishes to receive medication counseling from the Pharmacist. An Intern may provide medication counseling at the discretion and under the direct supervision of a pharmacist.

5. Obtain all information necessary to dispense and bill Third Party prescriptions, such as Cardholder and Dependent Identification numbers, person codes, Insurance Carrier or Pharmacy Benefit Manager, and expiration dates (if applicable), and patient signatures.

6. Assist in entering patient, drug and prescription data into the computer. Match patient and birth date. Scan drug barcodes or enter NDC number into the computer system. Notify the pharmacist in the event of early fills or drug utilization review (DUR) messages. Ensure DAW

codes are entered correctly.

7. Assist in obtaining and returning medications to and from the pharmacy shelves.

8. Assist in counting, pouring, measuring, compounding and packaging of medication for dispensing to the patient.

9. Assist in answering the telephone according to Harris Teeter policy (Harris Teeter Pharmacy, this is ____________, may I help you?) An Intern may receive original telephone prescription orders at the discretion and under the supervision of a pharmacist.

10. Assist in calling or faxing refill authorizations to prescribers' offices. An Intern may receive telephone refill authorizations from the prescriber or designee.

11. Assist in bagging of prescriptions and handling customer transactions, including cash register operation.

12. Assist in ordering receiving, verifying, pricing, and stocking of pharmaceuticals and other products. This function may require lifting up to 40 lbs., and reaching heights from 6 inches to 72 inches.

13. If the hours worked by the Intern are to apply towards requirements for licensure, the Intern will provide all relevant paperwork to the supervising pharmacist (Preceptor). The Intern will work cooperatively with the Preceptor in the development and meeting of expectations to be fulfilled during the internship.

ADDITIONAL JOB FUNCTIONS:

1. Assist in maintaining a clean, neat department including work counter, shelves, floors, windows, and customer service area to present a professional, sanitary and organized image to customers.

2. Assist in ordering, stocking and retrieving prescription containers and other supplies as required by the pharmacy including ordering and stocking the RX OTC section.

3. Assist in filing of prescriptions, reports, invoices and other documents as required by the pharmacy.

4. Adhere to all policies and procedures, dress code and work ethics.

5. Effectively communicate with customers, management, and associates.

MANDATORY JOB QUALIFACATIONS:

Successful completion of 30 or more credit hours at an accredited school of pharmacy. (NOTE: 30 HOURS IMPLES ONE YEAR).

PRINCIPAL WORKING RELATIONSHIPS:

Customers Pharmacy Associates, Medical Office Staff, Store Management, Store Associates, Regional Management, District Management, Corporate Management, and Support Staff.

Additional Information
  • Posting Date: May 26, 2026
Compensation

What Harris Teeter employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply