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Remote Case Reviewer Jobs in Raleigh, NC (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Raleigh, NC · On-site +1

$51 - $62.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

CVS Health

Case Manager, Registered Nurse

Raleigh, NC · Remote

$54.10K - $155.54K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Perform medical necessity reviews. Required Qualifications * 5+ years' experience as a Registered ...

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Remote Case Reviewer information

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$18

$46

$77

How much do remote case reviewer jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote case reviewer in Raleigh, NC is $46.21, according to ZipRecruiter salary data. Most workers in this role earn between $34.33 and $55.87 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Case Reviewer, and why are they important?

To thrive as a Remote Case Reviewer, you need strong analytical skills, attention to detail, and relevant professional credentials, often in fields like healthcare, insurance, or law. Familiarity with case management software, electronic documentation systems, and industry regulations (such as HIPAA for healthcare) is typically required. Excellent written communication, time management, and independent decision-making are standout soft skills for this role. These abilities ensure accurate, compliant, and efficient case evaluations while maintaining high-quality standards in a remote work environment.

What are some common challenges Remote Case Reviewers face, and how can they effectively manage them?

Remote Case Reviewers often encounter challenges such as managing a high volume of cases, staying organized with digital documentation, and maintaining clear communication with team members across different locations. To address these, it's important to develop strong time management skills, utilize standardized review checklists, and take advantage of collaboration tools like secure messaging platforms. Regular virtual meetings and clear protocols help ensure consistency and quality, while ongoing training can keep reviewers up to date on best practices.

What are remote case reviewers?

Remote case reviewers are professionals who assess and evaluate cases, such as medical, legal, or insurance files, from a remote location rather than working on-site. Their responsibilities typically include reviewing documentation, ensuring compliance with policies and regulations, and providing recommendations or decisions based on their findings. Remote case reviewers use secure digital platforms to access and analyze case materials, enabling flexibility and efficiency in their work. This role can be found in industries like healthcare, law, insurance, and finance. Strong attention to detail and analytical skills are essential for success in this position.

What is the difference between Remote Case Reviewer vs Remote Claims Processor?

AspectRemote Case ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; healthcare or legal background often preferredHigh school diploma or equivalent; experience in insurance or claims processing beneficial
Work EnvironmentHome-based, independent review settingHome-based, processing insurance claims
Industry UsageHealthcare, legal, insurance sectorsInsurance companies, third-party administrators
Common Search/ComparisonRemote Case Reviewer vs Remote Claims Processor

While both roles are remote and involve handling cases or claims, Remote Case Reviewers primarily evaluate and assess cases, often requiring specialized knowledge in healthcare or legal fields. Remote Claims Processors focus on processing insurance claims, verifying information, and ensuring accurate payment. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.

What are the most commonly searched types of Case Reviewer jobs in Raleigh, NC? The most popular types of Case Reviewer jobs in Raleigh, NC are:
What are popular job titles related to Remote Case Reviewer jobs in Raleigh, NC? For Remote Case Reviewer jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Case Reviewer jobs in Raleigh, NC look for? The top searched job categories for Remote Case Reviewer jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Case Reviewer jobs? Cities near Raleigh, NC with the most Remote Case Reviewer job openings:
Remote Case Reviewer jobs near you
Infographic showing various Remote Case Reviewer job openings in Raleigh, NC as of May 2026, with employment types broken down into 88% Full Time, 6% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $96,108 per year, or $46.2 per hour.

Case Management Pharmacist (Remote)

Pharmacy Careers

Raleigh, NC • On-site, Remote

Other

Posted 4 days ago

Job description

Case Management Pharmacist - Coordinate Care and Improve Patient Outcomes
A confidential managed care organization is hiring a detail-oriented Case Management Pharmacist to support patients with complex medication needs. This role focuses on coordinating care, preventing medication-related issues, and ensuring members receive the most appropriate therapy at the right time.
Key Responsibilities

  • Collaborate with physicians, nurses, and care coordinators to manage high-risk or complex patients.
  • Conduct medication reviews to identify gaps in therapy, adherence concerns, or potential drug interactions.
  • Support prior authorization and appeals processes when needed.
  • Educate patients and caregivers on medication regimens and disease state management.
  • Document case activities and outcomes in compliance with health plan and regulatory standards.
  • Participate in quality improvement initiatives to reduce hospitalizations and improve health outcomes.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Case management, MTM, or managed care experience preferred - retail and hospital pharmacists with strong patient counseling backgrounds are encouraged to apply.
  • Skills: Strong communication, problem-solving, and care coordination skills.


Why This Role?

  • Impact: Make a meaningful difference in patients' lives by ensuring safe and effective medication use.
  • Growth: Develop expertise in case management and managed care pharmacy.
  • Flexibility: Many organizations offer hybrid or fully remote work options.
  • Rewards: Competitive pay, benefits, and career advancement opportunities.

About Us
We are a confidential healthcare partner serving health plans and provider networks nationwide. Our case management pharmacists play a vital role in improving outcomes, reducing readmissions, and supporting patients across the continuum of care.
Apply Today
Apply now for our Case Management Pharmacist opportunity and join a team dedicated to patient-centered, coordinated care.

Apply