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Physical Therapy Utilization Review Jobs in Raleigh, NC

Pivot Physical Therapy

Physical Therapist

NC · On-site

$75K - $100K/yr

Physical therapy isn't just about recovery; it's about transformation. Our team thrives on ... Base pay ranges are reviewed and typically updated each year. Offers are made within the base pay ...

EmergeOrtho

Physical Therapy Assistant

Smithfield, NC · On-site

$24.25 - $32/hr

Conducts evaluations including reviewing patients' medical histories, testing and measuring ... Conduct research in physical therapy * Advise on health risks in the workplace and home and on ...

Pivot Physical Therapy

Physical Therapist

Raleigh, NC

$100K/yr

Physical Therapy/Occupational Therapy benefits as an employee * Bereavement Time Off & Resources ... Base pay ranges are reviewed and typically updated each year. Offers are made within the base pay ...

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

Physical Therapy Utilization Review information

See Raleigh, NC salary details

$15

$31

$52

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

As of Sep 1, 2026, the average hourly pay for physical therapy utilization review in Raleigh, NC is $31.05, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $39.47 per hour, depending on experience, location, and employer.

What is physical therapy utilization review?

Physical Therapy Utilization Review is a process in which healthcare professionals evaluate the necessity, efficiency, and appropriateness of physical therapy services provided to patients. Utilization review specialists assess patient records, treatment plans, and progress to ensure that therapy services are evidence-based and meet insurance or regulatory guidelines. This helps control healthcare costs, prevents unnecessary treatments, and ensures patients receive optimal care. Utilization review can be conducted by physical therapists, nurses, or other qualified professionals within insurance companies, hospitals, or third-party organizations.

What are the key skills and qualifications needed to thrive as a physical therapy utilization review specialist?

To thrive as a Physical Therapy Utilization Review specialist, you need a solid background in physical therapy, clinical assessment, and knowledge of insurance guidelines, typically requiring a valid PT license and clinical experience. Familiarity with utilization management software, electronic health records (EHR), and compliance documentation systems is often necessary. Strong analytical skills, attention to detail, and clear communication help in evaluating treatment plans and collaborating with providers. These competencies are essential for ensuring appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What are some common challenges faced in a physical therapy utilization review role, and how can I prepare for them?

Professionals in Physical Therapy Utilization Review often face the challenge of balancing clinical judgment with payer guidelines and policies. Reviewing cases requires strong attention to detail, as well as the ability to interpret medical records efficiently while ensuring compliance with insurance requirements. You may also encounter situations where you need to communicate complex decisions to clinicians or patients, so strong communication and negotiation skills are essential. Staying current with evidence-based practices and insurer protocols will help you navigate these challenges effectively.

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

AspectPhysical Therapy Utilization ReviewPhysical Therapist
CredentialsTypically requires a license in healthcare or related field, with additional training in utilization reviewRequires a state license as a licensed physical therapist, with DPT degree
Work EnvironmentMostly office-based, reviewing patient records and insurance claimsClinical settings, hospitals, outpatient clinics, providing direct patient care
Employer & Industry UsageInsurance companies, healthcare organizations, utilization review companiesHospitals, outpatient clinics, rehab centers, private practices

Physical Therapy Utilization Review focuses on evaluating the necessity and appropriateness of physical therapy services for insurance and healthcare compliance, often working behind the scenes. In contrast, a Physical Therapist provides direct patient care, developing treatment plans and performing therapy sessions. Both roles require healthcare knowledge, but their daily tasks and work environments differ significantly.

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

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

What are popular job titles related to Physical Therapy Utilization Review jobs in Raleigh, NC?

For Physical Therapy Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Physical Therapy Utilization Review jobs in Raleigh, NC look for?

The top searched job categories for Physical Therapy Utilization Review jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Physical Therapy Utilization Review jobs?

Cities near Raleigh, NC with the most Physical Therapy Utilization Review job openings:

Physical Therapy Utilization Review jobs near you
Infographic showing various Physical Therapy Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Hybrid job distribution, with an average salary of $64,581 per year, or $31 per hour.

Utilization Review Specialist

Raleigh, NC • On-site

Lifepoint Health
Health Care and Social Assistance • 10K+ employees

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

766th of 898 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about Lifepoint Healthexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Job description


Your experience matters
Lifepoint Behavioral Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina, providing care for patients with mental health and substance use disorders. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier®. Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to manage care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Job Responsibilities
  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
  • Complete pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
  • Works with DON to ensure documentation requirements are met.
  • Ensure appeals are completed thoroughly and on a timely basis.
  • Interface with managed care organizations, external reviews, and other payers.
  • Communicate with physicians to schedule peer-to-peer reviews.

What we're looking for
Education: Bachelor's degree required. Master's degree preferred.
Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
License: Current unencumbered clinical license strongly preferred.
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
Comprehensive Benefits: Multiple levels of medical, dental, and vision coverage for full-time and part-time employees
Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off
Financial & Career Growth: Tuition reimbursement and 401(k) retirement package with company match
Employee Well-being: Mental, physical, and financial wellness programs, including Employee Assistance Program and discount programs
Professional Development: Ongoing learning and career advancement opportunities
Additional Perks: Shift differentials and set schedules
EEOC Statement
Lifepoint Behavioral Health is an Equal Opportunity Employer. Lifepoint Behavioral Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.
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About LifePoint Health

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Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

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Benefits

Hours and flexibility

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