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Nicu Utilization Review Jobs in Raleigh, NC (NOW HIRING)

HCS 247

Travel ICU RN

Chapel Hill, NC · On-site

$1.7K - $2.3K/wk

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

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How much do nicu utilization review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for nicu 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 NICU Utilization Review?

A NICU Utilization Review job involves assessing the medical necessity, efficiency, and appropriateness of neonatal intensive care unit (NICU) services. Professionals in this role review patient records, insurance policies, and hospital guidelines to ensure that care aligns with best practices and payer requirements. They collaborate with medical teams and insurance providers to support optimal patient outcomes while managing healthcare costs. Strong clinical knowledge, attention to detail, and communication skills are essential for this role.

What are the key skills and qualifications needed to thrive in the NICU Utilization Review position, and why are they important?

To excel as a NICU Utilization Review professional, you need a background in neonatal or pediatric nursing, a thorough understanding of clinical guidelines, and experience with healthcare utilization management. Familiarity with medical coding systems (such as ICD-10, CPT), electronic medical record (EMR) platforms, and often certification such as CCM (Certified Case Manager) or URAC accreditation is highly valued. Outstanding analytical thinking, communication skills, and attention to detail are essential for reviewing complex cases and collaborating with multidisciplinary teams. These skills are critical to ensure appropriate resource use, regulatory compliance, and the delivery of optimal patient care in the neonatal intensive care unit setting.

What are the primary responsibilities of a NICU Utilization Review specialist on a typical day?

A NICU Utilization Review specialist is responsible for reviewing neonatal patient cases to ensure medical necessity for continued hospitalization, appropriateness of care, and compliance with payer requirements. Daily tasks include analyzing clinical documentation, communicating with NICU care teams and physicians, and preparing reports or recommendations for insurance authorization. You may also interact with families regarding coverage and participate in case conferences. This role requires close collaboration with both clinical and administrative staff to optimize patient outcomes while managing healthcare resources efficiently.

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Nicu Utilization Review jobs near you
Infographic showing various Nicu Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 4% As Needed, 70% Full Time, 13% Part Time, 4% Temporary, and 9% Contract. Highlights an 96% In-person, and 4% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Hospitalist Physician - Neonatal Intensive Care (NIGHTS / NICU Nocturnist)

Duke Health

Durham, NC • On-site

Full-time

Re-posted 28 days ago

Duke Health rating

7.3

Company rating: 7.3 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

Job description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of Duke Health's four hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Job Location: Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Job Summary
This position will provide direct patient care services and medical management of infants under the age of 2, who are in the Neonatal intensive care unit at Duke University Hospital (DUH), while working closely with and under the supervision of a Neonatologist. This includes seeing patients in the level 4 and level 2 NICUs affiliated with Duke University Health System (DUHS).In this role, providers will be expected to perform physical exam, collect and interpret patient related data, present patient related information on daily rounds, generate an assessment and care plan, implement diagnostic and therapeutic interventions, collaborate with consulting services, counsel family members, and prescribe medications, nutrition, and therapies for patients in the NICU, in conjunction with a multidisciplinary team.Other tasks include delivery room attendance, participation in neonatal resuscitation, performing common neonatal procedures, ventilator management along with respiratory therapists, participating in regular care meetings, and facilitating transitions in care and discharge home, along with NICU support staff, trainees and physicians.
Job Duties and Responsibilities
  • In collaboration with the attending physician and fellows, round daily on patients to assess, diagnose, plan treatment, set priorities, and evaluate the effectiveness and cost efficiency of patient care.
  • Provide and coordinate clinical care for service-specific patients per established protocols and unit guidelines, under the supervision of attending physician, who is either on site or available by pager.
  • Collaborate with fellows, residents, attendings, APP colleagues, nurses, dietitians, pharmacists, social workers, and patient care managers to formulate treatment plans, facilitate care progression, and monitor patient progress.
  • Work collaboratively with NICU APP team members, sharing their model for workflow, documentation, handoff, and communication in the NICU
  • Attend daily huddles in the NICU to discuss patient flow and situational awareness, weekly huddles to discuss care progression and discharge planning.
  • Work closely with medical director and APP team leads of the NICU to understand standard protocols, guidelines and workflows in the NICU.
  • Perform procedures specific to the work environment after demonstrating competency and within the scope of practice and credentialing protocols.
  • Assess patients for a change in status, escalate concerns and institute appropriate interventions. Initiate emergency interventions to stabilize the patient until more support arrives.
  • Post-procedural stabilization and management for patients returning to the NICU after a surgical or procedural intervention
  • Assist with bedside surgeries in the NICU along with multidisciplinary NICU, surgery and anesthesia teams..
  • Participate in developing patient care pathways, protocols, and guidelines for managing specific problems in conjunction with other members of the health care team.
  • Communicate verbally and in writing all pertinent patient information to the supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
  • Document in the patients' medical records all relevant data, including, but not limited to, diagnostic test results, laboratory results, patients' condition and response to therapies/interventions, and communications with the supervising MD.
  • Prescriptive authority for prescribing, ordering, and/or administering drugs, including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
  • Give daily handoff to appropriate attending, APP, or fellow/resident at the end of the shift.
  • Assess the educational needs of the patients/families and provide culturally sensitive patient/family education interventions as indicated. Use non-technical language when educating patients and families. Document all education in patients' medical records.
  • Maintain all professional requirements for licensure and certification.

Job Eligibility Requirements
Education
  • MD or DO graduate from an accredited medical school program and completion of Pediatrics, Family Practice or Medicine-Pediatrics Residency.

Licensure
  • Unrestricted medical license issued by NCMB.
  • Federal and State prescriptive authority (DEA license)

Certification
  • ABP or ABFM (board eligible recent or pending graduates may also apply)
  • BLS, NRP mandatory before hire

Experience
  • Candidates early in their career or finishing their Pediatric, Med-Peds, or Family Medicine residency and interested in a gaining additional experience in Neonatology are encouraged to apply.

Job Hours
Position includes 11 x 12-hour shifts per month from 7p-7a.Shifts will include week nights and weekend nights.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

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