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Full Time Remote Utilization Review Jobs in Raleigh, NC

Centene

Psychologist Reviewer

Durham, NC · On-site +1

$87K - $157K/yr

Centene is Hiring - Remote Psychologist Reviewers (ABA) Centene is seeking Remote Psychologist ... Interact with network practitioners to provide education on best practice models and utilization ...

Hitachi

Transformer Diagnostic Specialist

Raleigh, NC · On-site +1

Engineering & Science Job Schedule: Full time Remote: No For our transformer service business ... asset utilization, and minimizing downtime. The ideal candidate will bring strong expertise in ...

City of Durham, NC

Stormwater Review Manager

Durham, NC · On-site +1

$93K - $149K/yr

... Full time with benefits Remote Employment: Flexible/Hybrid Job Number: 26-05828 Department ... Coordinates the preparation and review of, and/or prepares and reviews complex technical plans ...

Pavago

Executive Assistant

Raleigh, NC · Remote

Hours Calendar, Travel, Executive Support Position Type: Full-Time, Remote Working Hours: U.S ... Review calendar and prepare executive briefing notes * Manage inbox, filter priorities, and draft ...

Pavago

Executive Assistant

Raleigh, NC · Remote

Hours | Calendar, Travel, Executive Support Position Type: Full-Time, Remote Working Hours: U.S ... Review calendar and prepare executive briefing notes * Manage inbox, filter priorities, and draft ...

Pavago

Executive Assistant

Raleigh, NC · Remote

Hours | Calendar, Travel, Executive Support Position Type: Full-Time, Remote Working Hours: U.S ... Review calendar and prepare executive briefing notes * Manage inbox, filter priorities, and draft ...

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Showing results 21-40

All JobsUtilization Review JobsFull Time Remote Utilization Review JobsFull Time Remote Utilization Review Jobs in Raleigh, NC

Full Time Remote Utilization Review information

See Raleigh, NC salary details

$20

$41

$67

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

As of Sep 3, 2026, the average hourly pay for full time remote 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 the difference between Full Time Remote Utilization Review vs Part Time Remote Utilization Review?

AspectFull Time Remote Utilization ReviewPart Time Remote Utilization Review
Work HoursTypically 40 hours/weekFewer hours, often less than 20/week
CertificationsRequired certifications like AAHAM or URAC often neededSame certifications as full-time, but may vary by employer
Work EnvironmentRemote, full-time employmentRemote, part-time engagement
Job ResponsibilitiesComplete utilization reviews, documentation, complianceSimilar responsibilities but on a reduced schedule

Full Time Remote Utilization Review involves working 40 hours weekly with comprehensive responsibilities, while Part Time Remote Utilization Review offers flexible, reduced hours with similar duties. Both roles require relevant certifications and are performed remotely, but differ mainly in hours and workload.

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

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

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For Full Time Remote Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:

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The top searched job categories for Full Time Remote Utilization Review jobs in Raleigh, NC are:

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

Full Time Remote Utilization Review jobs near you

Clinical Service Evaluator II (Full-Time Remote, North Carolina Based)

Alliance

Morrisville, NC • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 14 days ago

Job description

This position plans, designs, implements, conducts, and reports program evaluations of services delivered to recipients, including process/implementation evaluation, outcome evaluation, and cost benefit analysis. Ensures that services delivered are consistent with funding requirements, best practices, provider contracts and federal/state rules and regulations. Utilizes both qualitative and quantitative evaluation methods. Interprets data, analyzes results using statistical techniques and assures that results are disseminated in written and oral formats in a manner that promotes continuous quality improvement. Reviews and synthesizes existing research and evaluation information on priority topics for Alliance to ensure programs and service decisions are informed and guided by research, including appropriate expectations about return on investment for programs, and identification of promising alternatives for underperforming services.
This position is a provisional appointment that is tied to recurring funding. The extension of the position past June 2027 is dependent on ongoing funding.
This position is remote. The selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.
Responsibilities & Duties
Design Evaluation Projects Based on Program Plans
  • Establishes provider performance and service outcome measures, collects and analyzes performance information; plans and manages evaluations
  • Develops, designs, and implements evaluation projects based on sound and valid research methods and statistical techniques
  • Designs and implements evaluations and focused studies that address immediate concerns, identifies root causes of concerns, writes summary of findings/recommendations, and communicates to Alliance departments and/or providers as needed
  • Reviews existing data, literature research, and a review of pertinent Web sites and other Internet-accessible materials to gather information that will facilitate understanding of the program or activity to be reviewed and to identify the criteria applicable to the evaluation of the program or activity

Conduct all Aspects of the Evaluation Projects Within Timelines
  • Acquires data from primary and secondary data sources and maintains data sets for ongoing data analysis
  • Evaluates the quality of service provided to the MCO and develops, measures, and analyzes provider outcomes consistent with research and expected results
  • Reviews and analyzes data on service fidelity, service implementation processes and quality of services
  • Implements established process and outcome monitoring methodologies
  • Identifies, analyzes, and interprets trends or patterns in complex data sets
  • Performs all aspects of data analysis

Write and Deliver Briefings, Presentations, Summaries and Reports of Findings and Recommendations
  • Prepares accurate reports documenting findings, and ensuring adequate documentation and methodology to support findings and recommendations
  • Creates professional charts, data reports, and presentations related to assigned data/evaluation/research projects
  • Facilitates communication of data with internal and external stakeholders
  • Assists in developing and delivering instructional materials and providing technical assistance related to evaluation studies, quality reviews, data analysis, and reporting, as requested

Inter-departmental Collaboration to Promote use of Evaluation Processes and Results in a Way that Promotes Continuous Quality Improvement
  • Participates in internal committees as assigned, creates, and delivers presentations that are clear and complete
  • Develops and maintains professional and positive working relationships with all Alliance departments, contracted network providers, and stakeholders

Minimum Requirements
Education & Experience
Required:
Bachelor's degree in sociology, economics, psychology or related social science from an accredited college or university and two (2) years post degree, progressively responsible experience in gathering, editing, and analyzing data for social and economic research, including experience directly related to data analysis and research evaluation or statistics.
Preferred:
Professional with at least five (5) years of experience in the field of behavioral health, and statistics, program evaluation or quality management.
Knowledge, Skills, & Abilities
  • Strong analytical skills with the ability to collect, organize, and analyze data using statistical techniques with attention to detail
  • Proficiency in evaluation methods and techniques
  • Strong quantitative and qualitative data analysis skills
  • Expert written and oral communication skills
  • Strong data visualization and infographic reporting
  • Experience with statistics and experience using statistical packages for analyzing datasets (Microsoft Access, SQL)
  • Proficiency in advanced functions of Microsoft Office Excel
  • Advanced skills in Word, PowerPoint, and data visualization
  • Knowledge of best and promising practices for behavioral health and/or intellectual/developmental disabilities

Salary Range
$61,439 - $79,871/ Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
  • Medical, Dental, Vision, Life, Long Term Disability
  • Generous retirement savings plan
  • Flexible work schedules including hybrid/remote options
  • Paid time off including vacation, sick leave, holiday, management leave
  • Dress flexibility

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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