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Full Time Optum Utilization Review Jobs in Raleigh, NC

sequenceqcs

Engineering Consultant

Morrisville, NC

Engineering drawing review (PFDs, P&IDs, Wiring Diagrams, etc.) * Draft and execute startup test ... Strong technical writing skills and proficient utilization of MS Word, Excel, Visio, PowerPoint ...

Walmart

(USA) Maintenance Manager (grocery)

Chapel Hill, NC · On-site

$104K - $156K/yr

... utilization and preparing reviewing andor analyzing business reports Monitor and ensure area of ... full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high ...

Walmart

(USA) Maintenance Manager (grocery)

Morrisville, NC · On-site

$104K - $156K/yr

... utilization and preparing reviewing andor analyzing business reports Monitor and ensure area of ... full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high ...

Actalent

Pharmacist

Cary, NC · Hybrid

$57.25 - $68.75/hr

... reviews of pharmacotherapy for each patient, including drug utilization, adherence and compliance ... The Clinical Pharmacist will be on site full-time for the first six months, including an initial 3 ...

Walmart

(USA) Maintenance Manager (grocery)

Durham, NC · On-site

$104K - $156K/yr

... utilization and preparing reviewing andor analyzing business reports Monitor and ensure area of ... full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high ...

Actalent

Pharmacist

Cary, NC · Hybrid

$57.25 - $68.75/hr

... reviews of pharmacotherapy for each patient, including drug utilization, adherence and compliance ... The Clinical Pharmacist will be on site full-time for the first six months, including an initial 3 ...

Sequence, Inc.

Engineering Consultant

Morrisville, NC · On-site

Engineering drawing review (PFDs, P&IDs, Wiring Diagrams, etc.) * Draft and execute startup test ... Knowledge and utilization of regulatory compliance standards and quality assurance within regulated ...

Walmart

(USA) Maintenance Manager (grocery)

Carrboro, NC · On-site

$104K - $156K/yr

... utilization and preparing reviewing andor analyzing business reports Monitor and ensure area of ... full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high ...

UnitedHealth Group

Senior Software Engineer

Raleigh, NC · Remote

$91K - $163K/yr

Our Company Optum is a global organization that delivers care, aided by technology to help millions ... Drive technical excellence through code reviews, automation, DevOps best practices, performance ...

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All JobsOptum Utilization Review JobsFull Time Optum Utilization Review JobsFull Time Optum Utilization Review Jobs in Raleigh, NC

Full Time Optum Utilization Review information

See Raleigh, NC salary details

$20

$41

$67

How much do full time optum utilization review jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for full time optum 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 is a full time Optum utilization review?

A Full Time Optum Utilization Review position involves working for Optum, a healthcare services company, to review patient medical records and determine the medical necessity and appropriateness of healthcare services. Utilization Review professionals collaborate with healthcare providers, insurers, and patients to ensure that care provided is efficient, cost-effective, and aligns with established guidelines. The role typically requires knowledge of clinical standards, strong communication skills, and the ability to interpret medical documentation. Full-time positions often come with benefits and require standard weekly work hours.

What are the key skills and qualifications needed to thrive as a full time Optum utilization review?

To thrive as a Full Time Optum Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and platforms like InterQual or MCG is typically required. Excellent communication, critical thinking, and attention to detail are vital soft skills for effectively coordinating care and collaborating with providers. These abilities ensure efficient, compliant care management, cost containment, and optimal patient outcomes within the healthcare system.

What are some common challenges faced by full time Optum utilization review, and how can they be managed?

Full Time Optum Utilization Review nurses often encounter challenges such as managing high caseloads, staying updated with frequently changing insurance and regulatory guidelines, and effectively communicating with both healthcare providers and patients. Time management and strong organizational skills are crucial for balancing documentation with timely case reviews. Collaborating closely with multidisciplinary teams and utilizing technology tools provided by Optum can help streamline workflows and ensure compliance with policies, ultimately leading to more effective patient care coordination.

What is the difference between Full Time Optum Utilization Review vs Full Time Medical Reviewer?

AspectFull Time Optum Utilization ReviewFull Time Medical Reviewer
CertificationsTypically requires medical licenses and utilization review certificationsRequires medical licenses, often with additional certifications in utilization review
Work EnvironmentInsurance companies, healthcare organizations, remote or office-basedHospitals, clinics, insurance companies, often in clinical settings
Employer & Industry UsagePrimarily in health insurance and managed careIn healthcare facilities and insurance sectors

Full Time Optum Utilization Review professionals focus on evaluating medical necessity for insurance claims, often working remotely or in insurance settings. Full Time Medical Reviewers also assess medical necessity but may work directly within clinical environments. Both roles require medical credentials and involve reviewing patient records, but their work settings and employer types differ slightly.

What are the most commonly searched types of Optum Utilization Review jobs in Raleigh, NC?

The most popular types of Optum Utilization Review jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Full Time Optum Utilization Review jobs?

Cities near Raleigh, NC with the most Full Time Optum Utilization Review job openings:

Full Time Optum Utilization Review jobs near you

Genetic Counseling Assistant Laboratory (Temporary) - Referral Testing Services

Chapel Hill, NC • On-site

UNC Health Careers
Health Care and Social Assistance • 10K+ employees
Learn more about UNC Health Careersexternal

$23.24 - $33.41/hr

Full-time, Temporary

This job post has expired 3 days ago. Applications are no longer accepted.

Key responsibilities

  • Review test requisitions, order forms, and documentation for completeness and accuracy.

  • Track test status, facilitate communication with providers regarding results or additional documentation needs, and coordinate with reference laboratories for send-out testing.

  • Maintain internal test information databases, assist in drafting educational materials, and support data collection and reporting for lab performance.

UNC Health rating

7.0

Company rating: 7.0 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

***This is a Temporary role***

Summary: 

The Laboratory Genetic Counseling (GC) Assistant provides technical and administrative support to Certified Genetic Counselors (CGCs) in a laboratory setting. This non-patient-facing role focuses on supporting genetic testing workflows, documentation, order review, quality initiatives, and provider communication. The Laboratory GC Assistant plays a vital role in ensuring accurate, efficient, and compliant delivery of genetic testing services across the health system. 

Responsibilities:

Genetic Counseling Support:

  • Review test requisitions, order forms, and documentation for completeness and accuracy.
  • Track test status and facilitate communication with providers regarding results or additional documentation needs.
  • Coordinate with reference laboratories for send-out testing, clarify orders, and assist with test selection guidance.
  • Monitor genetic testing workflows and utilization patterns, escalating complex or potentially redundant or duplicative testing scenarios to CGCs.

Administrative and Operational Support:

  • Maintain internal test information databases, testing logs, and documentation systems related to clinical genetic testing.
  • Assist in drafting laboratory technologist or clinical provider-facing educational materials under CGC supervision.
  • Facilitate routine communication with providers regarding test results or procedural updates.
  • Support data collection and reporting for lab service performance and case tracking.

Quality and Research Support:

  • Assist CGCs in tracking and analyzing test utilization, redundant testing, or inappropriate test orders.
  • Help manage quality assurance initiatives by documenting specimen issues and updating workflows.
  • Maintain internal reference materials and testing requirements.
  • Support the implementation of new lab interfaces, protocols or workflow improvements based on evolving genetic testing standards.
Other Information

Education Requirements:

  • Bachelor's degree in Genetics, Biology, Health Science, or a related field.

Knowledge/Skills/and Abilities Requirements:

  • Strong understanding of genetic terminology and knowledge of laboratory workflows.
  • Detail-oriented with strong organizational skills
  • Proficiency in data entry and basic database tools
  • Excellent written and verbal communication
  • Experience in laboratory or healthcare environments preferred but not required


Job Details

Legal Employer: STATE

Entity: UNC Medical Center

Organization Unit: Referral Testing Services

Work Type: Temporary Full Time

Standard Hours Per Week: 40.00

Salary Range: $23.24 - $33.41 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No


This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.


Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.

Employment Type:

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