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Remote Utilization Management Jobs in Raleigh, NC

Huntington

Commercial Portfolio Mgr III

Raleigh, NC · On-site +1

Conduct portfolio reviews with senior management and analyze existing portfolio to identify trends ... Understanding and utilization of credit skills for credit decision making, monitoring, and managing ...

OptiTrack

Machine Learning & Operations Engineer

Durham, NC · Remote

$71K - $96K/yr

This is a fully remote position, working cross-functionally with research and engineering teams ... Optimize GPU/compute utilization across cloud and on-prem environments. * Deploy, monitor, and ...

OptiTrack

Machine Learning & Operations Engineer

Durham, NC · Remote

$67K - $90K/yr

This is a fully remote position, working cross-functionally with research and engineering teams ... Optimize GPU/compute utilization across cloud and on-prem environments. * Deploy, monitor, and ...

OptiTrack

Machine Learning & Operations Engineer

Durham, NC · Remote

$67K - $90K/yr

This is a fully remote position, working cross-functionally with research and engineering teams ... Optimize GPU/compute utilization across cloud and on-prem environments. * Deploy, monitor, and ...

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All JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Raleigh, NC

Remote Utilization Management information

See Raleigh, NC salary details

$20

$41

$67

How much do remote utilization management jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for remote utilization management 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.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Raleigh, NC? The most popular types of Utilization Management jobs in Raleigh, NC are:
What are popular job titles related to Remote Utilization Management jobs in Raleigh, NC? For Remote Utilization Management jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Raleigh, NC look for? The top searched job categories for Remote Utilization Management jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Utilization Management jobs? Cities near Raleigh, NC with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you

Associate Project Management Director (m/f/d)

Optimapharm d.o.o.

Durham, NC • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Key responsibilities

  • Lead complex, full-service global projects and portfolio.

  • Support business development activities, including RFPs, feasibility assessments, proposal development, and bid defenses.

  • Act as a senior client-facing leader, ensuring client satisfaction, audit readiness, financial accountability, and quality excellence.

Job description

Location: This role is open to applicants located anywhere in the United States (remote-friendly)
Who we are?
Optimapharm is a mid-sized, global Contract Research Organisation (CRO) turning science into hope through agile, patient-focused clinical development. We specialise in Phase I-IV clinical studies, delivering Full-Service and Functional Service Provision (FSP) solutions that help sponsors move faster and execute with confidence.
With operations in 40+ countries and 2x the patient reach of the average mid-sized CRO, we enable accelerated regulatory pathways, faster study start-up, and access to diverse patient populations worldwide. At Optimapharm, you'll contribute to meaningful clinical research while growing your career in a dynamic, people‑focused, global environment.
As an Associate Project Management Director at Optimapharm US, you will lead complex global trials while stepping into a strategic role that combines project leadership with Business Development support. This position is ideal for a strong Project Manager ready to influence delivery standards, contribute to BD, and drive successful outcomes across Phase I-III studies.
What do we offer?
  • Working in a successful company that's growing and developing every day
  • Being part of a clinical research team that transforms science into hope for patients
  • International projects and professional growth
  • Company that supports life balance
  • Company with healthy culture
  • Working with a highly experienced team of clinical research professionals
  • Competitive salary
  • Competitive PTO entitlement
  • Health insurance, including vision and dental plans, to meet your and your family's needs
  • Comprehensive pension plan to maximize savings and prepare confidently for the future
  • Employee engagement programs
  • Well-being initiatives
  • Training and development program
  • Fast-paced career path progression

Who are we looking for?
Qualifications and Experience
  • University degree, in Medical or Life Sciences (or equivalent)
  • Minimum 8 years of clinical research experience, preferably in both pharma and CRO environments
  • Minimum 4 years of global project management experience (EU, NA, APAC) within CRO environment
  • Experience in managing global oncology projects is a plus
  • Strong knowledge of ICH-GCP, ICH Guidelines, CTR/CTIS, ISO 14155, and MEDDEV/MDCG
  • Understanding of drug development processes and with experience in end-to-end project execution
  • Organized, proactive, and thrives in fast-paced teams
  • Excellent communication, interpersonal, and negotiation skills; able to work effectively in a matrix environment
  • Proven leadership and mentoring capabilities
  • Tech-savvy with project management tools and MS Office
  • Fluent in English
  • Sharp analytical and numerical skills
  • Valid driver's license and willingness to travel (up to 20%)

Your responsibilities
  • Lead complex, full-service global projects, and portfolio.
  • Deliver strong project oversight, risk management, vendor governance, and strategic guidance to Project Team.
  • Own and monitor portfolio and project KPIs, including milestones, margins, revenues, compliance, and operational performance.
  • Lead people management and development, including performance reviews, training, utilization, and conflict resolution.
  • Ensure accurate reporting, systems usage, and documentation across CTMS, LMS, eTMF, and related platforms.
  • Act as a senior client-facing leader, ensuring client satisfaction, audit readiness, financial accountability, and quality excellence.
  • Lead and optimize resourcing strategy, including monthly forecasting, succession planning, and external vendor collaboration.
  • Drive a high-performance culture within the Project Management team, ensuring on-time, on-budget, and high-quality delivery.
  • Support business development activities, including RFPs, feasibility assessments, proposal development, and bid defenses.
  • Provide expert regulatory intelligence, ensuring compliance with GCP, ISO 14155, and evolving global regulations.
  • Shape and continuously improve project management methodologies, SOPs, tools, and reporting frameworks.

If you would be interested in joining the Optimapharm team, please send your CV and note that only shortlisted candidates who meet the requirements will be contacted for the further selection process.
Compensation is competitive and final offers will reflect each candidate's experience, skills, and qualifications.
Disclaimer: Unsolicited CVs sent to Optimapharm (Talent Acquisition Team, Hiring Managers or any other OPT employee) by recruitment agencies will not be considered for this role. Optimapharm follows a direct sourcing strategy and collaborates exclusively with selected recruitment partners when external support is required.

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