Raleigh, NC · On-site
$340K/yr
Provides clinical leadership, including directing treatment plans, participating in on-call coverage, advising multidisciplinary staff, and supporting utilization review efforts. * Serves as a key ...
Raleigh, NC · On-site
$340K/yr
Provides clinical leadership, including directing treatment plans, participating in on-call coverage, advising multidisciplinary staff, and supporting utilization review efforts. * Serves as a key ...
Leads evaluation of public health programs, quality assurance, utilization review, and ... Advises Health Director on emerging occupational health needs and compliance issues.
Leads evaluation of public health programs, quality assurance, utilization review, and ... Advises Health Director on emerging occupational health needs and compliance issues.
Leads evaluation of public health programs, quality assurance, utilization review, and ... Advises Health Director on emerging occupational health needs and compliance issues.
Leads evaluation of public health programs, quality assurance, utilization review, and ... Advises Health Director on emerging occupational health needs and compliance issues.
Wake Forest, NC · On-site
$95K - $157K/yr
The Nurse Director oversees inpatient medical and behavioral health nursing operations, urgent care, specialty clinics, perioperative services, Medical Records, and Utilization Review, while building ...
New
Wake Forest, NC · On-site
$95K - $157K/yr
The Nurse Director oversees inpatient medical and behavioral health nursing operations, urgent care, specialty clinics, perioperative services, Medical Records, and Utilization Review, while building ...
New
Raleigh, NC · On-site
$95K - $157K/yr
The Nurse Director oversees inpatient medical and behavioral health nursing operations, urgent care, specialty clinics, perioperative services, Medical Records, and Utilization Review, while building ...
Raleigh, NC · On-site
$95K - $157K/yr
The Nurse Director oversees inpatient medical and behavioral health nursing operations, urgent care, specialty clinics, perioperative services, Medical Records, and Utilization Review, while building ...
Raleigh, NC · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
Raleigh, NC · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
... when conducting utilization review or an appeals consideration and cannot be located on a US ... Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MED > Licensed ...
New
... when conducting utilization review or an appeals consideration and cannot be located on a US ... Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MED > Licensed ...
New
Smithfield, NC · Hybrid
$211K - $269K/yr
Ensure the integrity and quality of utilization management activities, including initial reviews ... Director OneNote--to complete timely utilization reviews in Alliance's UM platform and perform ...
Smithfield, NC · Hybrid
$211K - $269K/yr
Ensure the integrity and quality of utilization management activities, including initial reviews ... Director OneNote--to complete timely utilization reviews in Alliance's UM platform and perform ...
Durham, NC · On-site
$248K - $298K/yr
Participates in Utilization Review inclusive of but not limited to ED visits, hospitalizations, SNF ... Director's role. * Protects privacy and maintains confidentiality of all company procedures ...
New
Durham, NC · On-site
$248K - $298K/yr
Participates in Utilization Review inclusive of but not limited to ED visits, hospitalizations, SNF ... Director's role. * Protects privacy and maintains confidentiality of all company procedures ...
New
Morrisville, NC · Hybrid
$211K - $269K/yr
Ensure the integrity and quality of utilization management activities, including initial reviews ... Director OneNote--to complete timely utilization reviews in Alliance's UM platform and perform ...
Morrisville, NC · Hybrid
$211K - $269K/yr
Ensure the integrity and quality of utilization management activities, including initial reviews ... Director OneNote--to complete timely utilization reviews in Alliance's UM platform and perform ...
$248K - $298K/yr
Participates in Utilization Review inclusive of but not limited to ED visits, hospitalizations, SNF ... Director's role. * Protects privacy and maintains confidentiality of all company procedures ...
Quick apply
$248K - $298K/yr
Participates in Utilization Review inclusive of but not limited to ED visits, hospitalizations, SNF ... Director's role. * Protects privacy and maintains confidentiality of all company procedures ...
Medical Director Associate - CarelonRx Location: This role enables associates to work virtually ... when conducting utilization review or an appeals consideration and cannot be located on a US ...
New
Medical Director Associate - CarelonRx Location: This role enables associates to work virtually ... when conducting utilization review or an appeals consideration and cannot be located on a US ...
New
Raleigh, NC · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization ... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ...
Raleigh, NC · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization ... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ...
Raleigh, NC · On-site
$95 - $96/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
Raleigh, NC · On-site
$95 - $96/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
Raleigh, NC · On-site
$95 - $109/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
Raleigh, NC · On-site
$95 - $109/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...
Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable ... Knowledge of utilization management processes preferred. * Must haves: Medicare knowledge ...
Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable ... Knowledge of utilization management processes preferred. * Must haves: Medicare knowledge ...
Durham, NC · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... directors as needed. * Serves as a clinical resource to other pharmacists on areas such as ...
Durham, NC · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... directors as needed. * Serves as a clinical resource to other pharmacists on areas such as ...
Durham, NC · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... directors as needed. * Serves as a clinical resource to other pharmacists on areas such as ...
Durham, NC · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... directors as needed. * Serves as a clinical resource to other pharmacists on areas such as ...
Direct Operational Oversight: Lead daily supply chain operations across 67 procedural areas at DUH ... Advance cost stewardship through rigorous utilization review, contract compliance, inventory ...
Direct Operational Oversight: Lead daily supply chain operations across 67 procedural areas at DUH ... Advance cost stewardship through rigorous utilization review, contract compliance, inventory ...
Collaboration with Medical Directors Maintain adequate time management as the workload is high and ... Transplant Medical Necessity Review experience in a Utilization Management environment or ...
Collaboration with Medical Directors Maintain adequate time management as the workload is high and ... Transplant Medical Necessity Review experience in a Utilization Management environment or ...
$17.5K - $23.3K
1% of jobs
$23.3K - $29.2K
3% of jobs
$29.2K - $35K
11% of jobs
$38.8K is the 25th percentile. Wages below this are outliers.
$35K - $40.8K
16% of jobs
$40.8K - $46.7K
15% of jobs
The median wage is $48.4K / yr.
$46.7K - $52.5K
16% of jobs
$57.3K is the 75th percentile. Wages above this are outliers.
$52.5K - $58.3K
17% of jobs
$58.3K - $64.2K
9% of jobs
$64.2K - $70K
7% of jobs
$70K - $75.8K
3% of jobs
$75.8K - $81.7K
2% of jobs
$17.5K
$50.9K
$81.7K
| Aspect | Director Optum Utilization Review | Utilization Review Manager |
|---|---|---|
| Certifications | Typically requires certifications like CCM or URAC accreditation | Often requires similar certifications, may vary by employer |
| Work Environment | Works within Optum or similar healthcare organizations, overseeing utilization review processes | Manages utilization review teams, often within healthcare providers or insurance companies |
| Responsibilities | Strategic oversight of utilization review policies, compliance, and team leadership | Supervises daily review operations, staff management, and process improvements |
The main difference is that the Director Optum Utilization Review typically holds a higher strategic leadership role within Optum, focusing on policy and compliance, while the Utilization Review Manager manages daily operations and staff. Both roles require similar credentials but differ in scope and level of responsibility.
The most popular types of Optum Utilization Review jobs in Raleigh, NC are:
Cities near Raleigh, NC with the most Director Optum Utilization Review job openings:
Raleigh, NC • On-site
$340K/yr
Other
Medical, Retirement, PTO
Posted 8 days ago
Medical Director I (NS)
Salary Range: $170,121.00 - 340,243.00
This position is located at Central Prison Healthcare Complex, Raleigh, NC. Central Prison is a close-custody prison housing male offenders. Central Prison serves as the hub for healthcare for the male inmate population. The facility is designed to house a maximum capacity of 1104 offenders. The Medical Director supports the Chief of Integrated Mental Health Services by providing leadership for psychiatric and behavioral health care. They supervise physicians and physician extenders, work closely with the hospital director, wardens, and clinical leaders, and ensure that patients receive appropriate, high quality care. The role helps develop and implement medical/psychiatric/behavioral health policies, procedures, and operating standards for the Department of Adult Correction and oversees their consistent use across facilities.
Administrative Responsibilities & Duties:
The State of North Carolina offers a comprehensive benefits package including:
Applicants must complete the application in full. Resumes will not be accepted in lieu of completing the State application. Applications must include:
Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, NCDAC will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.
Recruiter: Monique Williams Cowan
Email: DACWorkday@dac.nc.gov
