Clayton, NC · On-site
$94K - $119K/yr
PRN-NP-CLAY-9.1.26 Department: Operations Location: Clayton, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Clayton, NC · On-site
$94K - $119K/yr
PRN-NP-CLAY-9.1.26 Department: Operations Location: Clayton, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Oxford, NC · On-site
$101K - $128K/yr
PRN-NP-OXFO-9.1.26 Department: Operations Location: Oxford, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Oxford, NC · On-site
$101K - $128K/yr
PRN-NP-OXFO-9.1.26 Department: Operations Location: Oxford, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Clayton, NC · On-site
$94K - $119K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Clayton, NC · On-site
$94K - $119K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Smithfield, NC · On-site
$95K - $121K/yr
PRN-NP-SMIT-5.20.26 Department: Operations Location: Smithfield, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Smithfield, NC · On-site
$95K - $121K/yr
PRN-NP-SMIT-5.20.26 Department: Operations Location: Smithfield, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
$94K - $120K/yr
PRN-NP-WAKE0-9.1.26 Department: Operations Location: Wake Forest, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
$94K - $120K/yr
PRN-NP-WAKE0-9.1.26 Department: Operations Location: Wake Forest, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Wake Forest, NC · On-site
$94K - $120K/yr
PRN-NP-WAKE-5.20.26 Department: Operations Location: Wake Forest, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Wake Forest, NC · On-site
$94K - $120K/yr
PRN-NP-WAKE-5.20.26 Department: Operations Location: Wake Forest, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Clayton, NC · On-site
$94K - $119K/yr
PRN-NP-CLAY-5.19.26 Department: Operations Location: Clayton, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Clayton, NC · On-site
$94K - $119K/yr
PRN-NP-CLAY-5.19.26 Department: Operations Location: Clayton, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Oxford, NC · On-site
$101K - $128K/yr
PRN-NP-OXFO-5.20.26 Department: Operations Location: Oxford, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Oxford, NC · On-site
$101K - $128K/yr
PRN-NP-OXFO-5.20.26 Department: Operations Location: Oxford, NC Description PRN Family Nurse ... General orthopedic evaluations and management * X-ray review (with Radiologist over-read) * EKG ...
Utilization Management Representative I Utilization Management Representative I Location : This ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Representative I Utilization Management Representative I Location : This ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Raleigh, NC · On-site
$107K - $136K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Raleigh, NC · On-site
$107K - $136K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Raleigh, NC · On-site
$83 - $124/hr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Raleigh, NC · On-site
$83 - $124/hr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Raleigh, NC · On-site
$107K - $136K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Raleigh, NC · On-site
$107K - $136K/yr
Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required
Chapel Hill, NC · On-site
Provide same-day urgent/symptom-based evaluations to reduce ED utilization * Manage chemotherapy ... Attend and contribute to divisional conferences, case reviews, and morbidity and mortality ...
Chapel Hill, NC · On-site
Provide same-day urgent/symptom-based evaluations to reduce ED utilization * Manage chemotherapy ... Attend and contribute to divisional conferences, case reviews, and morbidity and mortality ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Cary, NC · On-site
$111K - $143K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Cary, NC · On-site
$111K - $143K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Cary, NC · On-site
$95 - $135/hr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Cary, NC · On-site
$95 - $135/hr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission , values , and management of WakeMed. Department Description ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission , values , and management of WakeMed. Department Description ...
Raleigh, NC · On-site
$85 - $110/hr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Raleigh, NC · On-site
$85 - $110/hr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
Raleigh, NC · On-site
$97K - $125K/yr
... reviewed annually during the annual review process. The PA/NP understands the needs of the ... organization and supports the mission, values and management of WakeMed. Basic Life Support ...
$69K - $81.3K
3% of jobs
$81.3K - $93.7K
7% of jobs
$93.7K - $106K
12% of jobs
$107K is the 25th percentile. Wages below this are outliers.
$106K - $118.3K
34% of jobs
$118.3K - $130.7K
9% of jobs
$141.3K is the 75th percentile. Wages above this are outliers.
$130.7K - $143K
12% of jobs
$143K - $155.3K
6% of jobs
$155.3K - $167.6K
5% of jobs
$167.6K - $180K
5% of jobs
$180K - $192.3K
3% of jobs
$192.3K - $204.6K
3% of jobs
$69K
$130.6K
$204.6K
A Nurse Practitioner Utilization Review (NP UR) job involves evaluating medical records to ensure treatments are medically necessary, cost-effective, and compliant with healthcare guidelines. NP UR professionals work with insurance companies, healthcare organizations, or government agencies to review patient care decisions, approve or deny claims, and recommend alternative treatments when needed. They use clinical expertise to assess whether services align with best practices and healthcare policies. This role is typically non-clinical, involving case reviews, documentation, and collaboration with healthcare providers. It helps improve patient care efficiency while controlling costs.
A Nurse Practitioner Utilization Review typically spends their day evaluating patient records, determining medical necessity of treatments, and ensuring care meets established guidelines and payer requirements. This role involves frequent collaboration with physicians, case managers, and insurance representatives to clarify or appeal decisions as needed. You may also participate in team meetings, develop recommendations for optimizing utilization, and provide education to clinical staff regarding documentation or policy changes. The work is often remote or office-based, with a predictable schedule and minimal direct patient contact. This structure allows for a balanced workload and a focus on analytical aspects of patient care.
To thrive as a Nurse Practitioner Utilization Review, you need advanced clinical knowledge, current NP licensure, and expertise in reviewing medical records for appropriateness of care. Familiarity with utilization management software, ICD-10/CPT coding, and case management systems is typically required, along with relevant certifications such as URAC or CCM. Strong analytical thinking, attention to detail, effective written communication, and collaboration skills help you excel in evaluating care plans and working with multi-disciplinary teams. These abilities ensure accurate assessment of healthcare services, optimal resource use, and regulatory compliance within healthcare organizations.
The most popular types of Nurse Practitioner Utilization Review jobs in Raleigh, NC are:
For Nurse Practitioner Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
The top searched job categories for Nurse Practitioner Utilization Review jobs in Raleigh, NC are:
Cities near Raleigh, NC with the most Nurse Practitioner Utilization Review job openings:
$94K - $119K/yr
Per diem
Re-posted 28 days ago
2.5
Based on 7 frontline employees who took The Breakroom Quiz
PRN Family Nurse Practitioner - Clayton, NC
Looking for supplemental income? Or maybe you work in a specialized setting and want to keep your full skill set sharp?
At MainStreet Family Care, we're growing fast and looking for fast, fun, and friendly PRN Family Nurse Practitioners (FNPs) to work across multiple clinics in your region. Our providers help patients feel better FAST! Boom!
This role is ideal for someone who enjoys variety, thrives in a high-volume environment, and is flexible working with different teams and clinics. New grads are encouraged to apply!
Responsibilities:
Schedule:
MainStreet Clinic Hours:
KidsStreet Clinic Hours (select locations only):
Hours are subject to change based on company needs, training, float coverage, etc.
Qualifications:
Compensation & Benefits:
MAINSTREET FAMILY CARE IS AN EQUAL OPPORTUNITY EMPLOYER
Standard pre-employment background checks and drug screens are performed.
Alternatively, you can apply to this job using your profile from Indeed by clicking the button below:
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance
201 - 500 Employees
Birmingham, AL, US
2013
