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Discharge Planner Utilization Review Jobs in Raleigh, NC

Duke Health

Utilization Manager

Durham, NC · On-site

Reviews records for medical necessity and collaborates with physician (s) and members of the care ... to discharge planning and utilization management. * Ongoing collaboration with Case Manager to ...

Duke Health

Utilization Manager

Durham, NC · On-site

Reviews records for medical necessity and collaborates with physician (s) and members of the care ... to discharge planning and utilization management. * Ongoing collaboration with Case Manager to ...

Duke University

Utilization Manager

Durham, NC · On-site

Reviews records for medical necessity and collaborates with physician (s) and members of the care ... to discharge planning and utilization management. * Ongoing collaboration with Case Manager to ...

Duke University

Utilization Manager

Durham, NC · On-site

Reviews records for medical necessity and collaborates with physician (s) and members of the care ... to discharge planning and utilization management. * Ongoing collaboration with Case Manager to ...

Duke Health

Utilization Manager

Durham, NC · On-site

Reviews records for medical necessity and collaborates with physician (s) and members of the care ... to discharge planning and utilization management. * Ongoing collaboration with Case Manager to ...

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Discharge Planner Utilization Review information

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$31

$57

How much do discharge planner utilization review jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for discharge planner utilization review in Raleigh, NC is $31.71, according to ZipRecruiter salary data. Most workers in this role earn between $22.45 and $38.08 per hour, depending on experience, location, and employer.

What is a discharge planner utilization review?

Discharge Planner Utilization Review professionals are healthcare workers who coordinate patient discharges from hospitals or medical facilities while ensuring appropriate utilization of healthcare services. They assess patients' continuing care needs, develop safe discharge plans, and review the necessity and efficiency of the care provided. Their role bridges clinical care and administrative requirements, helping to prevent unnecessary hospital stays and ensuring patients transition smoothly to home or other care settings. These professionals often work closely with physicians, nurses, social workers, and insurance companies to promote optimal patient outcomes and cost-effective healthcare.

How does a discharge planner utilization review collaborate with interdisciplinary teams to ensure effective patient transitions?

Discharge Planner Utilization Review professionals work closely with physicians, nurses, social workers, and insurance representatives to coordinate safe and timely patient discharges. They facilitate communication between team members, assess patients' post-hospital needs, and help secure appropriate resources such as home health care or rehabilitation services. Their role is vital in preventing readmissions by ensuring that all aspects of a patient's care plan are addressed and that transitions occur smoothly. Regular interdisciplinary meetings and case conferences are common practices to align on patient care goals.

What are the key skills and qualifications needed to thrive as a discharge planner utilization review?

To thrive as a Discharge Planner Utilization Review professional, you generally need a clinical background such as RN or social worker licensure, strong knowledge of discharge planning protocols, and familiarity with healthcare regulations. Proficiency with electronic health records (EHRs), case management software, and utilization review tools is typically required. Excellent communication, problem-solving, and organizational skills help in coordinating care and advocating for patient needs. These competencies ensure safe, efficient patient transitions and compliance with healthcare policies, ultimately optimizing patient outcomes and resource use.

What is the difference between Discharge Planner Utilization Review vs Discharge Planner?

AspectDischarge Planner Utilization ReviewDischarge Planner
Primary RoleEvaluates medical necessity and appropriateness of patient discharges for insurance and healthcare complianceCoordinates patient discharges, ensures proper placement, and communicates with healthcare teams
CredentialsTypically requires a social work, nursing, or healthcare background with certification in utilization reviewUsually requires social work or nursing credentials, with focus on discharge planning
Work EnvironmentHospitals, insurance companies, or healthcare facilities involved in utilization reviewHospitals, rehab centers, or skilled nursing facilities

While both roles involve discharge processes, Discharge Planner Utilization Review focuses on assessing medical necessity for insurance purposes, whereas Discharge Planner manages patient discharge logistics and coordination. Understanding these differences helps clarify career paths and employer expectations in healthcare settings.

What are popular job titles related to Discharge Planner Utilization Review jobs in Raleigh, NC?

For Discharge Planner Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Discharge Planner Utilization Review jobs in Raleigh, NC look for?

The top searched job categories for Discharge Planner Utilization Review jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Discharge Planner Utilization Review jobs?

Cities near Raleigh, NC with the most Discharge Planner Utilization Review job openings:

Discharge Planner Utilization Review jobs near you
Infographic showing various Discharge Planner Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,958 per year, or $31.7 per hour.

Utilization Review Nurse

Oxford, NC

Granville Health System

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

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Respectful managers

Learn more about Granville Health Systemexternal

Per diem

Re-posted 6 days ago

Job description

Position Summary:

Conducts patient reviews as specified in review plan using screening criteria; identifies and documents actual and potential delays in services or treatment and works with departments and other providers to resolve problems; communicates to attending physician need for documentation for admission or continuation of hospitalization; refers cases that do not meet criteria to Director when needed. Screens all cases against high risk screens for discharge planning; conduct concurrent and retrospective reviews.

Qualifications:

North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization management criteria and standards. Excellent communication skills. Ability to work with physicians and hospital staff. Maintains professional knowledge and skills related to areas of responsibility. Self direction with the ability to work with minimal supervision and manage multiple tasks. Demonstrates understanding of variations in care of the following age groups - newborn, infant, child, adolescent, adult and geriatric.

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