The Utilization Management Nurse performs medical necessity and benefit review requests in ... Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality ...
Quick apply
The Utilization Management Nurse performs medical necessity and benefit review requests in ... Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality ...
The Utilization Management Nurse performs medical necessity and benefit review requests in ... to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed ...
The Utilization Management Nurse performs medical necessity and benefit review requests in ... to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed ...
Supervisor II Facility-Based Care Managers (Full-time Remote, North Carolina Based)
Morrisville, NC · On-site +1
... care, case management and plans of care Provide Customer Service * Develop strong working ... Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of ...
Supervisor II Facility-Based Care Managers (Full-time Remote, North Carolina Based)
Morrisville, NC · On-site +1
... care, case management and plans of care Provide Customer Service * Develop strong working ... Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of ...
Supervisor II Facility-Based Care Managers (Full-time Remote, North Carolina Based)
Morrisville, NC · On-site +1
... care, case management and plans of care Provide Customer Service * Develop strong working ... Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of ...
Supervisor II Facility-Based Care Managers (Full-time Remote, North Carolina Based)
Morrisville, NC · On-site +1
... care, case management and plans of care Provide Customer Service * Develop strong working ... Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of ...
EHR Epic Analyst
Cary, NC · Remote
Remote (Based in Raleigh, NC) Position Type: Contract We are seeking an experienced EHR Epic ... Provide expertise in Epic tools , including Clinical Case Management, Rover, MyChart Bedside ...
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EHR Epic Analyst
Cary, NC · Remote
Remote (Based in Raleigh, NC) Position Type: Contract We are seeking an experienced EHR Epic ... Provide expertise in Epic tools , including Clinical Case Management, Rover, MyChart Bedside ...
... evaluations, managing medications, and developing individualized treatment plans for diverse patient populations. This position offers the flexibility of remote work while allowing you to make a ...
... evaluations, managing medications, and developing individualized treatment plans for diverse patient populations. This position offers the flexibility of remote work while allowing you to make a ...
Senior Pega Developer
Raleigh, NC · Remote
$130K - $139K/yr
Remote Citizenship: Must be a US Citizen or Permanent Resident Security Clearance: USDA Public ... Hands-on experience with Pega Platform case management, workflows, UI configuration, data pages ...
Senior Pega Developer
Raleigh, NC · Remote
$130K - $139K/yr
Remote Citizenship: Must be a US Citizen or Permanent Resident Security Clearance: USDA Public ... Hands-on experience with Pega Platform case management, workflows, UI configuration, data pages ...
Masters or bachelor's level degree in health sciences (e.g., RN, RPh, PA, NP, etc.) would be ... Remote #LI-Full-time
Masters or bachelor's level degree in health sciences (e.g., RN, RPh, PA, NP, etc.) would be ... Remote #LI-Full-time
Graduation from an accredited school of Nursing and three (3) years of full-time, post degree experience providing care management, case management, care coordination, discharge planning, or ...
Graduation from an accredited school of Nursing and three (3) years of full-time, post degree experience providing care management, case management, care coordination, discharge planning, or ...
Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ... Flexible, remote scheduling * No-cost continuing education courses and clinical workshops tailored ...
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Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ... Flexible, remote scheduling * No-cost continuing education courses and clinical workshops tailored ...
A thriving group is seeking a Remote Radiologist to provide Swing Shift and Night Shift Teleradiology services - No Call! Contact: Raymond Stiles 843-574-8233 raymond@nowhealthcare.org About the ...
A thriving group is seeking a Remote Radiologist to provide Swing Shift and Night Shift Teleradiology services - No Call! Contact: Raymond Stiles 843-574-8233 raymond@nowhealthcare.org About the ...
Remote Medical Scribe
Durham, NC · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
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Remote Medical Scribe
Durham, NC · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
... management * Manage publication and medical-writing agencies, including scope definition ... Advanced terminal degree (PharmD, MD, DO, DNP) or other advanced medical degree (NP, PA, RN etc ...
... management * Manage publication and medical-writing agencies, including scope definition ... Advanced terminal degree (PharmD, MD, DO, DNP) or other advanced medical degree (NP, PA, RN etc ...
Medical Scribe (Remote)
Raleigh, NC · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Summary of Position Description: The Scribe-X medical scribe is a critical member ...
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Medical Scribe (Remote)
Raleigh, NC · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Summary of Position Description: The Scribe-X medical scribe is a critical member ...
Lead end-to-end workflow automation across support case management. * Define and track ... Familiarity with remote support tools and knowledge management systems. * Understanding of ...
Lead end-to-end workflow automation across support case management. * Define and track ... Familiarity with remote support tools and knowledge management systems. * Understanding of ...
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
Advanced terminal degree (PharmD, PhD, MD, DO,DNP) OR other advanced medical (NP, PA, RN etc.) is ... Remote #LI-Full-time
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
Quick apply
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
Remote Nurse Practitioner Case Management information
See Raleigh, NC salary details
$40.3K - $54.3K
1% of jobs
$54.3K - $68.4K
0% of jobs
$68.4K - $82.4K
2% of jobs
$82.4K - $96.4K
9% of jobs
$105.1K is the 25th percentile. Wages below this are outliers.
$96.4K - $110.4K
21% of jobs
The median wage is $120.1K / yr.
$110.4K - $124.4K
24% of jobs
$124.4K - $138.4K
17% of jobs
$138.9K is the 75th percentile. Wages above this are outliers.
$138.4K - $152.4K
14% of jobs
$152.4K - $166.4K
5% of jobs
$166.4K - $180.4K
3% of jobs
$180.4K - $194.4K
3% of jobs
$40.3K
$126.7K
$194.4K
How much do remote nurse practitioner case management jobs pay per year?
As of Sep 3, 2026, the average yearly pay for remote nurse practitioner case management in Raleigh, NC is $126,657.00, according to ZipRecruiter salary data. Most workers in this role earn between $105,000.00 and $145,800.00 per year, depending on experience, location, and employer.
What is the difference between Remote Nurse Practitioner Case Management vs Remote Physician Assistant Case Management?
| Aspect | Remote Nurse Practitioner Case Management | Remote Physician Assistant Case Management |
|---|---|---|
| Credentials | Master's in Nursing, Nurse Practitioner license | Master's in Physician Assistant Studies, PA license |
| Work Environment | Telehealth, insurance companies, healthcare providers | Telehealth, hospitals, clinics, insurance companies |
| Industry Usage | Common in patient management and care coordination | Used in similar roles but with a focus on diagnosis and treatment planning |
Remote Nurse Practitioner Case Management and Remote Physician Assistant Case Management share similar credentials and work environments, often involving telehealth and healthcare organizations. However, NPs focus more on patient care coordination and management, while PAs may be more involved in diagnosis and treatment planning. Both roles are vital in remote healthcare delivery, with overlapping responsibilities but distinct scopes of practice.
What are popular job titles related to Remote Nurse Practitioner Case Management jobs in Raleigh, NC?
For Remote Nurse Practitioner Case Management jobs in Raleigh, NC, the most frequently searched job titles are:
- Remote Non Clinical Nurse Practitioner
- Remote Womens Health Nurse Practitioner
- Remote Fertility Nurse Practitioner
- Remote Surgical Nurse Practitioner
- Nurse Practitioner Remote Virtual
- Remote Holistic Nurse Practitioner
- Inbox Nurse Practitioner Remote
- Remote Infectious Disease Nurse Practitioner
- Remote Reproductive Health Nurse
- Remote Critical Care Nurse Practitioner
What job categories do people searching Remote Nurse Practitioner Case Management jobs in Raleigh, NC look for?
The top searched job categories for Remote Nurse Practitioner Case Management jobs in Raleigh, NC are:
- Full Time Pfizer Nurse Practitioner
- Remote Asynchronous Nurse Practitioner
- Overnight Remote Nurse Practitioner
- Remote Cvs Nurse Practitioner
- Psychiatric Nursing Faculty Remote
- Psychiatric Mental Health Np
- Entry Level Nurse Practitioner Medical Writer
- Remote Nurse Practitioner Expert Witness
- Remote Anesthesia Nurse Practitioner
- Remote Snf Nurse Practitioner
What cities near Raleigh, NC are hiring for Remote Nurse Practitioner Case Management jobs?
Cities near Raleigh, NC with the most Remote Nurse Practitioner Case Management job openings:
Full-time
Re-posted 27 days ago
Job description
About The Role
BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely.
Primary Responsibilities
• Performs clinical utilization reviews using evidenced based guidelines, policies and nationally recognized clinical criteria and internal policies/procedures.
• Identifies potential Third-Party Liability and Coordination of Benefit Cases and notifies appropriate parties/departments.
• Collaborates with healthcare partners to ensure timely review of services and care.
• Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed.
• Develop and review member centered documentation and correspondence reflecting determinations in compliance with regulatory and accreditation standards
• Identifies potential quality of care issues, service or treatment delays and intervenes as clinically appropriate.
• Triages and prioritizes cases and other assigned duties to meet required turnaround times.
• Prepares and presents cases to Medical Director (MD) for medical director oversight and necessity determinations.
• Communicates determinations to providers and/or members in compliance with regulatory and accreditation requirements.
• Duties as assigned.
Essential Qualifications
• Current Licensed Practical Nurse (LPN) with state licensure. Must retain active and unrestricted licensure throughout employment.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Must be able to work independently.
• Must be detail oriented and have strong organizational and time management skills.
• Adaptive to a high pace and changing environment- flexibility in assignment.
• Proficient in Utilization Review process including benefit interpretation, contract language, medical and policy review.
• Proficient in MCG and CMS criteria sets
• Experience with both inpatient and outpatient reviews including Behavioral Health, DME, Genetic Testing, Clinical Trials, Oncology, and/or elective surgical cases preferred.
• Working knowledge of URAC and NCQA.
• 2+ years’ experience in a UM team within managed care setting.
• 3+ years’ experience in clinical nurse setting preferred.
• TPA Experience preferred.
BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely.
Primary Responsibilities
• Performs clinical utilization reviews using evidenced based guidelines, policies and nationally recognized clinical criteria and internal policies/procedures.
• Identifies potential Third-Party Liability and Coordination of Benefit Cases and notifies appropriate parties/departments.
• Collaborates with healthcare partners to ensure timely review of services and care.
• Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed.
• Develop and review member centered documentation and correspondence reflecting determinations in compliance with regulatory and accreditation standards
• Identifies potential quality of care issues, service or treatment delays and intervenes as clinically appropriate.
• Triages and prioritizes cases and other assigned duties to meet required turnaround times.
• Prepares and presents cases to Medical Director (MD) for medical director oversight and necessity determinations.
• Communicates determinations to providers and/or members in compliance with regulatory and accreditation requirements.
• Duties as assigned.
Essential Qualifications
• Current Licensed Practical Nurse (LPN) with state licensure. Must retain active and unrestricted licensure throughout employment.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Must be able to work independently.
• Must be detail oriented and have strong organizational and time management skills.
• Adaptive to a high pace and changing environment- flexibility in assignment.
• Proficient in Utilization Review process including benefit interpretation, contract language, medical and policy review.
• Proficient in MCG and CMS criteria sets
• Experience with both inpatient and outpatient reviews including Behavioral Health, DME, Genetic Testing, Clinical Trials, Oncology, and/or elective surgical cases preferred.
• Working knowledge of URAC and NCQA.
• 2+ years’ experience in a UM team within managed care setting.
• 3+ years’ experience in clinical nurse setting preferred.
• TPA Experience preferred.
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About Brighton Health Plan Solutions
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