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Remote Aetna Utilization Review Jobs in Raleigh, NC

Tihinsurance

Senior Treasury Analyst

Raleigh, NC · Remote

English (Required) Work Shift: 1st Shift (United States of America) Please review the following ... This role is remote, but we would prefer someone in Charlotte, Dallas, Birmingham, New York ...

ABB

Utility Sales Support

Cary, NC · Remote

$17.75 - $23.25/hr

While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred

Canals

Customer Success Manager

Raleigh, NC · Remote

Facilitate regular business reviews to demonstrate ROI and align on future goals. * Contribute to ... Demonstrated success driving product adoption, utilization and training end users. * Proven ...

TEKsystems

Mainframe Storage DB2

Raleigh, NC · Remote

$60 - $75/hr

... storage utilization, capacity thresholds and storage-group growth. Review and manage storage ... remote position. Application Deadline This position is anticipated to close on Aug 15, 2026. About ...

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All JobsAetna Utilization Review JobsRemote Aetna Utilization Review JobsRemote Aetna Utilization Review Jobs in Raleigh, NC

Remote Aetna Utilization Review information

See Raleigh, NC salary details

$20

$41

$67

How much do remote aetna utilization review jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for remote aetna 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 remote Aetna Utilization Review?

Remote Aetna Utilization Review jobs involve evaluating medical necessity, appropriateness, and efficiency of healthcare services provided to Aetna members. Professionals in these roles, often nurses or clinicians, review patient records and claims remotely to ensure treatments meet established guidelines and policies. The goal is to support quality care while managing healthcare costs and preventing unnecessary procedures. These positions require clinical experience, attention to detail, and familiarity with insurance processes.

What are the key skills and qualifications needed to thrive as a remote Aetna Utilization Review nurse?

To thrive as a Remote Aetna Utilization Review nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with Aetna's systems, utilization management software, and knowledge of medical necessity criteria such as MCG or InterQual are typically required. Excellent communication, attention to detail, and time management are vital soft skills for coordinating care and efficiently handling remote assessments. These skills ensure accurate evaluations, regulatory compliance, and optimal resource utilization in a healthcare payer setting.

What are some common challenges faced in a remote Aetna Utilization Review role and how can they be managed?

One common challenge in a remote Aetna Utilization Review position is maintaining effective communication with healthcare providers and internal teams, as much of the coordination happens virtually. To manage this, professionals often rely on secure digital communication tools and establish clear protocols for timely responses. Another challenge is staying updated with changing healthcare regulations and Aetna policies, which requires proactive learning and frequent collaboration with colleagues. Developing strong organizational skills and participating in regular virtual team meetings can help ensure efficient workflow and compliance.

What is the difference between Remote Aetna Utilization Review vs Remote UnitedHealthcare Utilization Review?

AspectRemote Aetna Utilization ReviewRemote UnitedHealthcare Utilization Review
CertificationsTypically requires nursing or healthcare-related licenses, certifications in utilization reviewSimilar licensing and certifications, often requiring nursing or healthcare credentials
Work EnvironmentRemote, healthcare insurance setting, reviewing medical necessity and coverageRemote, healthcare insurance setting, assessing medical claims and coverage appropriateness
Employer & Industry UsageUsed by Aetna insurance providers for member care managementUsed by UnitedHealthcare for claims review and member care decisions

Both Remote Aetna Utilization Review and Remote UnitedHealthcare Utilization Review involve remote assessments of medical necessity and coverage. They require similar healthcare credentials and operate within the health insurance industry, focusing on claims and member care management for their respective providers.

Does Aetna have remote jobs?

Aetna offers remote positions, including roles like Remote Utilization Review, which often require healthcare knowledge and familiarity with medical records. These jobs typically involve working from home with flexible schedules and may require relevant certifications or experience in healthcare or insurance industries.

Is remote Aetna utilization review work from home?

Remote Aetna utilization review jobs are often performed from home, allowing employees to review medical cases and authorization requests remotely. These roles typically require strong computer skills, familiarity with healthcare software, and adherence to confidentiality standards, with many positions offering flexible or full-time remote schedules.

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

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

What are popular job titles related to Remote Aetna Utilization Review jobs in Raleigh, NC?

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

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

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

What cities near Raleigh, NC are hiring for Remote Aetna Utilization Review jobs?

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

Remote Aetna Utilization Review jobs near you
Infographic showing various Remote Aetna Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 88% Full Time, 7% Part Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Senior Director, Strategic Client Programs

Well

Chapel Hill, NC • Remote

$175K - $200K/yr

Full-time

Medical

Re-posted 2 days ago

Job description

Description
Company: Well is a healthcare innovation company with the heart of a services organization and the DNA of a SaaS platform. Our Dynamic Engagement System transforms workforce health by uniting AI, human guidance, and proven behavioral science to reduce costs, improve outcomes, and create resilient, thriving workforces. We partner with the world's largest, most sophisticated employers and the consultants who advise them. We're a highly diverse and engaged organization whose employees are passionate about the mission of the company and whose management is passionate about the employees. We promote an employee- and member-centric culture with generous benefits, which you can learn more about here: https://www.well.co/careers.
Position Title: Senior Director, Strategic Client Programs
Reporting To: Vice President, Platform & Strategic Initiatives
Location:Chapel Hill, NC; Remote candidates will be considered, depending on location
Compensation: Senior Director, Strategic Client Platforms ($175,000 - $200,000), depending on qualifications and experience, plus bonus potential and benefits
Summary: Well is seeking a strategic and experienced client program leader to drive large-scale concierge program implementations and manage ongoing strategic program delivery for key private and public health plan clients, including those with retiree populations. The Senior Director, Strategic Client Programs will be responsible for end-to-end management of these multifaceted initiatives, overseeing operations, digital tools, marketing, and advanced analytics.
Key Responsibilities:
  • Program Strategy and Financial Oversight: Serve as the primary leader for the successful execution of the strategic client initiatives
  • Concierge Operations: Assist in coordination of concierge services, including subcontractor-provided services
  • Engagement and Marketing: Oversee the deployment of the public-facing digital education solution (webpage, dynamic FAQ, webinars/videos) and lead robust marketing and communications strategies (home mailers, email campaigns, outbound phone calls) to drive member awareness and utilization of the services.
  • Data, Analytics, and Insights: Establish and manage the strategic feedback loop that captures and analyzes every member interaction.
    • Oversee regular reporting and provide reviews of trends and behavioral insights to internal and client leadership.
    • Leverage advanced tools and analytics to measure program success and identify barriers/drivers
  • Stakeholder Management: Coordinate closely with Well's internal and external partners to align strategy, training, and operations with specialized Medicare/senior care expertise.

Requirements
  • Expert knowledge of Medicare plans (e.g., Medicare Advantage) and associated enrollment processes, as well as employee benefit plans.
  • Demonstrated ability to manage strategic partnerships and subcontractors
  • Experience in operations management, particularly in a high-touch service center environment, overseeing staff training and technology implementation.
  • Proven experience leading complex program initiatives in the healthcare or health plan space, ideally related to Medicare, retiree engagement, or navigation solutions.
  • Strong analytical skills with experience managing data-driven insights and reporting for executive decision-making.
  • MBA or relevant other graduate degree or equivalent experience.

Apply