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Occupational Therapy Utilization Review Jobs in Raleigh, NC

Granville County Schools

Occupational Therapist

Oxford, NC · On-site

$37 - $48.75/hr

... • Reviews occupational therapy services for quality improvement and makes changes as needed to ensure quality of services. Education • Teaches, monitors, and collaborates with educational ...

Central Office

Occupational Therapist

Oxford, NC · On-site

$37 - $48.75/hr

... • Reviews occupational therapy services for quality improvement and makes changes as needed to ensure quality of services. Education • Teaches, monitors, and collaborates with educational ...

UNC Health Careers

Occupational Therapist II

Chapel Hill, NC · On-site

$37 - $48.50/hr

... update reviews. Other Information Other information: Education Requirements: Graduation from an accredited Occupational Therapy program. Licensure/Certification Requirements: Licensed as an ...

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All JobsOccupational Therapy Utilization Review JobsOccupational Therapy Utilization Review Jobs in Raleigh, NC

Occupational Therapy Utilization Review information

See Raleigh, NC salary details

$22

$44

$65

How much do occupational therapy utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for occupational therapy utilization review in Raleigh, NC is $44.10, according to ZipRecruiter salary data. Most workers in this role earn between $37.60 and $49.52 per hour, depending on experience, location, and employer.

What is occupational therapy utilization review?

Occupational Therapy Utilization Review is a process where an occupational therapy professional evaluates the necessity, efficiency, and appropriateness of therapy services provided to patients. This role involves reviewing clinical documentation and treatment plans to ensure compliance with insurance and regulatory guidelines, as well as determining if services are medically necessary. The goal is to optimize patient care while also controlling healthcare costs and ensuring ethical practices. Utilization reviewers often work for insurance companies, healthcare organizations, or third-party review agencies, and may interact with therapists to clarify documentation or recommend changes to treatment plans.

What are the key skills and qualifications needed to thrive as an occupational therapy utilization review specialist, and why are they important?

To thrive as an Occupational Therapy Utilization Review specialist, you need a solid clinical background in occupational therapy, a valid OT license, and experience in case management or utilization review. Familiarity with electronic medical records (EMR) systems, insurance guidelines, and certifications such as CCM (Certified Case Manager) or URAC accreditation are often required. Strong critical thinking, attention to detail, and effective communication skills help professionals excel in evaluating treatment plans and collaborating with healthcare teams. These competencies ensure that care recommendations are evidence-based, cost-effective, and compliant with insurance and regulatory standards.

What is the difference between Occupational Therapy Utilization Review vs Occupational Therapist?

AspectOccupational Therapy Utilization ReviewOccupational Therapist
CredentialsTypically requires a background in occupational therapy, often with certification in utilization review or case managementRequires a state license and a master's degree in occupational therapy
Work EnvironmentPrimarily office-based, reviewing cases for insurance companies or healthcare organizationsClinical settings such as hospitals, clinics, or rehabilitation centers
Employer & IndustryInsurance companies, healthcare organizations, case management firmsHospitals, outpatient clinics, rehabilitation centers
Job FocusEvaluating medical necessity and approving or denying therapy servicesProviding direct therapy services to patients to improve daily functioning

Occupational Therapy Utilization Review focuses on assessing the necessity of therapy services through case evaluation, often in an office setting. In contrast, Occupational Therapists provide hands-on therapy to patients. While both roles require knowledge of occupational therapy, their work environments and responsibilities differ significantly.

What are some common challenges faced in an occupational therapy utilization review role, and how can they be addressed?

One common challenge in Occupational Therapy Utilization Review is balancing the need to ensure cost-effective care with advocating for appropriate patient services. Professionals in this role often navigate complex clinical documentation and must communicate effectively with both therapy providers and insurance representatives. Staying current on evolving payer guidelines and clinical best practices is essential. Developing strong analytical skills and fostering collaborative relationships with clinical teams can help address these challenges and support both patient outcomes and organizational goals.

What are utilization review jobs in occupational therapy?

Occupational therapy utilization review jobs focus on reviewing clinical records and documentation to ensure that patients of occupational therapists receive required services and an appropriate level of clinical care. Your duties also include collecting information for insurance purposes. In addition to insurance reimbursement and claim data, you also assess the available resources and staff skills in the facility that you are reviewing. Utilization review specialists can look at medical data, but they can also interview a patient or communicate with the occupational therapists who provide treatment to come up with evidence-based reports to support their review.

More about Occupational Therapy Utilization Review jobs
What are the most commonly searched types of Occupational Therapy Utilization Review jobs in Raleigh, NC? The most popular types of Occupational Therapy Utilization Review jobs in Raleigh, NC are:
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What job categories do people searching Occupational Therapy Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Occupational Therapy Utilization Review jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Occupational Therapy Utilization Review jobs? Cities near Raleigh, NC with the most Occupational Therapy Utilization Review job openings:
Occupational Therapy Utilization Review jobs near you
Infographic showing various Occupational Therapy Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 84% Full Time, 14% Part Time, and 2% Contract. Highlights an 90% In-person, 1% Hybrid, and 9% Remote job distribution, with an average salary of $91,735 per year, or $44.1 per hour.

Utilization Review Nurse (RN)

Integrated Resources INC

Raleigh, NC • On-site

Contractor

Re-posted 14 days ago

Job description

Company Description

A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care.

Advanced assessment and teaching skills.

Problem solving skills.

Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues.

Utilization and Quality Management/Outcomes experience preferred.

Previous work experience with a managed care organization or provider is also preferred.

Prior experience in case management, home health, discharge planning, or Concurrent review.



Qualifications

RN Diploma, RN Associate's degree or Bachelors of Science in Nursing (BSN) degree.

Minimum of 3 years clinical experience in an acute medical or acute surgical setting.

Proficiency with a Microsoft Windows operating system.

Must have valid license to practice nursing within the US and have started application for NC nursing license. 

Additional Information

With Regards,


Kavita Kumari

Allied Healthcare Recruiter

Integrated Resources, Inc

IT REHAB CLINICAL NURSING

Inc. 5000 - 2007-2014 (8th Year)

Certified MBE I GSA - Schedule 66 I GSA - Schedule 621I I GSA - Schedule 70

Tel: 732-549-2030 x208

Fax: 732-549-5549

Direct: 732-549-5302




Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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