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Case Reviewer Jobs in Raleigh, NC (NOW HIRING)

NCSU

Assistant Director / Case Manager

Raleigh, NC

... Case Manager Anticipated Hiring Range $65,000 - $75,000 Work Schedule Monday - Friday, 8am - 5pm ... Referrals are reviewed and appropriate follow-up actions are taken to support both the individual ...

CoreCivic

Case Processing Specialist - Cary, NC

Cary, NC · On-site

$31.53/hr

The Case Processing Specialist provides case processing and administrative support to Immigration ... Ensures all administrative applications are reviewed, A-files are updated, where applicable, and ...

Select Source International

Case Manager

Durham, NC · On-site

$19.25 - $25/hr

Prior experience in case management, home health, discharge planning, or Concurrent review. * Excellent communication and interpersonal skills with all levels of internal and external customers ...

Select Source International

Case Manager

Durham, NC · On-site

$19.25 - $25/hr

Prior experience in case management, home health, discharge planning, or Concurrent review. * Excellent communication and interpersonal skills with all levels of internal and external customers ...

Dlapiper

Case Manager

Raleigh, NC · Hybrid

$70.43 - $112/hr

This individual prepares drafts of legal and other documents and correspondence for attorney review ... Manages and trains case assistants, paralegals, and attorneys, delegates and supervises projects ...

Ignite Human Capital

Case Manager - (Hybrid)

Raleigh, NC · On-site

$70.43 - $112/hr

The Case Manager is a senior-level legal professional responsible for managing substantive and ... Draft legal documents, correspondence, summaries, and other materials for attorney review * Manage ...

Advocate Aurora Health

Case Manager SE

Wake Forest, NC · On-site

$38.20 - $57.30/hr

Experience 1. Minimum of five years of experience in the care of assigned patient population 2. Participation in case management and utilization review encouraged C. Licensure/Certification 1. ...

Advocate Aurora Health

Case Manager SE

Wake Forest, NC · On-site

$38.20 - $57.30/hr

Experience 1. Minimum of five years of experience in the care of assigned patient population 2. Participation in case management and utilization review encouraged C. Licensure/Certification 1. ...

Resources for Seniors, Inc.

Case Manager

Raleigh, NC · On-site

$44K/yr

The Case Manager, under the supervision of the Director, conducts support for the Medicaid Home ... Participates in regular staffing of caseload to review and assess beneficiaries progress;

BrightSpring

Foster Care Case Manager

Raleigh, NC

$49K - $51K/yr

The Foster Care Case Manager assists the Program Manager in developing individual treatment plans ... Reviews referrals and matches children with appropriate foster families. * Places children in state ...

Advocate Aurora Health

Case Manager NEX

Wake Forest, NC · On-site

$38.20 - $57.30/hr

... Utilization Review staff of necessary changes 9. Utilizes principles of quality improvement in ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...

Team Select Home Care

Case Manager

Raleigh, NC · On-site

$19.50 - $25/hr

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...

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How much do case reviewer jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for case reviewer in Raleigh, NC is $46.20, according to ZipRecruiter salary data. Most workers in this role earn between $34.33 and $55.87 per hour, depending on experience, location, and employer.

What is a case reviewer?

A Case Reviewer is responsible for evaluating case files, documents, and related information to ensure accuracy, compliance, and completeness. They analyze evidence, verify facts, and provide detailed assessments based on established guidelines or legal standards. Case Reviewers often work in legal, medical, insurance, or government sectors and must have strong attention to detail and analytical skills. Their role helps ensure fair and accurate decision-making in various professional settings.

What are the typical daily responsibilities of a case reviewer?

As a Case Reviewer, your day-to-day work commonly involves reviewing case files, supporting documents, and related evidence to assess compliance with relevant guidelines or policies. You may be required to write detailed reports, summarize findings, and make recommendations based on established criteria. Collaboration is frequent, as you often interact with other reviewers, supervisors, and subject matter experts to discuss complex cases or clarify information. This role demands a high level of organization and consistency, as accuracy and fairness are critical when determining outcomes that impact clients, patients, or other stakeholders.

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

To thrive as a Case Reviewer, you need strong analytical abilities, attention to detail, and a background in the relevant industry, often supported by a degree in law, healthcare, or a specialized field. Familiarity with case management software, electronic records systems, or regulatory databases is usually important, and certifications may be required for specialized roles. Excellent written communication, impartiality, and time management are soft skills that set top performers apart. Mastery of these skills ensures accurate, timely case evaluations and effective collaboration with stakeholders for informed decision-making.

What are the most commonly searched types of Case Reviewer jobs in Raleigh, NC?

The most popular types of Case Reviewer jobs in Raleigh, NC are:

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For Case Reviewer jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Case Reviewer jobs in Raleigh, NC look for?

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Cities near Raleigh, NC with the most Case Reviewer job openings:

Case Reviewer jobs near you
Infographic showing various Case Reviewer job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 76% Physical, 2% Hybrid, and 22% Remote job distribution, with an average salary of $96,103 per year, or $46.2 per hour.

Case Manager - Utilization Review

Oxford, NC • On-site

Granville Health System

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Good employer

Respectful managers

Learn more about Granville Health Systemexternal

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 8 days ago

Job description

Case Manager - Utilization Review
Location: Granville Health System, Oxford NC

About Granville Health System:

For over a century, Granville Health System has been at the forefront of quality healthcare. To cater to the evolving needs of its community, Granville Health System has extended its services throughout Granville County, ensuring convenient medical care access for its residents. The Granville Health System main campus can be found at 1010 College Street, Oxford, North Carolina. For more details, visit GHS online at www.ghsHospital.org.

About Oxford, NC

Oxford, NC is a charming and welcoming community that offers a perfect blend of small-town charm and modern convenience, making it an ideal place to live and work. Located just about 30 miles north of Durham and 40 miles from Raleigh. The region enjoys a mild, four-season climate with warm summers, crisp autumns, blooming springs, and gentle winters—perfect for enjoying the area's outdoor activities year-round. With a thriving local economy, excellent healthcare facilities, and a strong sense of community, its historic downtown, scenic parks, and proximity to the Research Triangle ensure a balanced lifestyle with both professional and personal fulfillment.

Position Overview:
The primary role of the Case Manager is to review and monitor members’ utilization of health care services with the goal of maintaining high quality, cost-effective care. This role will provide the medical and utilization review expertise necessary to evaluate patient status.  This includes reviewing clinical information against established criteria, assessing the medical necessity of services and procedures, collaborating with providers and interdisciplinary teams, and ensuring that the patient is placed at the appropriate level of care from the time of admission. This includes providing referral authorization, concurrent review, proactive discharge/transition planning, appropriate referral to case management, and high-dollar claims review.

Position Highlights:

  • Retirement Benefits: NC Local Government Pension Plan (5-year vesting period)
  • Loan Forgiveness: Eligible employer for Public Service Loan Forgiveness (PSLF)
  • Comprehensive Benefits: Medical, dental, vision, life insurance, and various supplemental benefits available

Key Responsibilities:

• Conduct concurrent review of all patients, regardless of payer source, using approved screening criteria

• Perform admission reviews on the first working day following admission

• Conduct continued stay reviews at least every three (3) days or more frequently as indicated

Qualifications

Associate degree in a healthcare-related field or equivalent combination of healthcare experience and education.                                                                    

At least a year of experience in a related role (utilization review, case management, care coordination, insurance authorization/prior authorization, clinical documentation review, hospital patient access or revenue cycle support, healthcare quality or compliance functions).

Strong attention to detail, organizational skills and interpersonal skills.  Ability to interpret clinical documentation and apply review criteria.  Strong communication skills for interaction with physicians and interdisciplinary teams.  Knowledge of healthcare regulations and payer requirements

Preferred

Bachelor’s degree in Health Administration, Public Health, Social Work, Healthcare Management, or related field. Accredited Case Manager (ACM) certification. 

Experience with insurance authorization criteria preferred; one year utilization and discharge planning experience.

Apply Today:
If you're a dedicated professional looking for a position with a focus on work-life balance and the opportunity to make a difference, we encourage you to apply for this position with Granville Health System.

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