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Remote Utilization Review Nurse Practitioner Jobs in Raleigh, NC

Clinical Director

Durham, NC ยท Remote

$90K - $100K/yr

Participate in utilization review meetings, representing patient needs in both clinical and ... Student Loan Repayment - Available for nurses and therapists. * Retirement Benefits - 401(k) plan ...

Review quality metrics, issue trends, audit findings, and operational performance indicators to ... Evaluate workload, utilization, productivity, quality, and customer satisfaction metrics. * Support ...

Review quality metrics, issue trends, audit findings, and operational performance indicators to ... Evaluate workload, utilization, productivity, quality, and customer satisfaction metrics. * Support ...

... Remote Patient Monitoring ("RPM") to bill under the patient's insurance. This is a major step ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

Direct, coach, mentor, and review the work of a team * Communicate regularly with clients and ... Manage team billable hours to maximize utilization and efficiency * Communicate regularly with ...

Showing results 41-60

Remote Utilization Review Nurse Practitioner information

See Raleigh, NC salary details

$69K

$130.6K

$204.6K

How much do remote utilization review nurse practitioner jobs pay per year?

As of Aug 23, 2026, the average yearly pay for remote utilization review nurse practitioner in Raleigh, NC is $130,618.00, according to ZipRecruiter salary data. Most workers in this role earn between $107,900.00 and $148,200.00 per year, depending on experience, location, and employer.

What is a remote utilization review nurse practitioner?

A Remote Utilization Review Nurse Practitioner is a licensed advanced practice nurse who evaluates the necessity, efficiency, and appropriateness of healthcare services, treatments, and hospital admissions, typically from a remote or home-based setting. They review patient medical records to ensure care meets established guidelines and insurance requirements, helping to control costs and ensure quality care. Their role often involves collaborating with physicians, insurance companies, and healthcare facilities to determine coverage and recommend alternative treatments when necessary. Working remotely, they rely heavily on electronic health records and telecommunication tools to perform their duties.

How does a remote utilization review nurse practitioner typically collaborate with healthcare teams while working offsite?

Remote Utilization Review Nurse Practitioners frequently collaborate with interdisciplinary teams through virtual meetings, secure messaging platforms, and electronic health record (EHR) systems. They work closely with physicians, case managers, and insurance representatives to review patient care plans, ensure medical necessity, and support appropriate resource utilization. Despite working remotely, maintaining clear communication and timely documentation is essential for seamless coordination and decision-making. Many organizations provide robust digital tools and regular team check-ins to facilitate collaboration and support remote staff.

What are the key skills and qualifications needed to thrive as a remote utilization review nurse practitioner, and why are they important?

To thrive as a Remote Utilization Review Nurse Practitioner, you need an advanced nursing degree (NP), active state licensure, and strong knowledge of clinical guidelines and insurance criteria. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) are often required. Critical thinking, strong communication, and a detail-oriented approach set top performers apart in this remote role. These skills ensure accurate, compliant, and efficient review of patient care while supporting healthcare cost management and patient advocacy.

What is the difference between Remote Utilization Review Nurse Practitioner vs Telehealth Nurse Practitioner?

AspectRemote Utilization Review Nurse PractitionerTelehealth Nurse Practitioner
CertificationsNP license, possibly certification in utilization reviewNP license, general telehealth certifications
Work EnvironmentReviewing medical records, insurance data remotelyProviding patient care via telehealth platforms
Employer & IndustryInsurance companies, healthcare organizationsHospitals, clinics, telehealth companies

The main difference is that Remote Utilization Review Nurse Practitioners focus on reviewing medical necessity and insurance claims remotely, while Telehealth Nurse Practitioners provide direct patient care via telehealth platforms. Both roles require NP licensure, but their daily tasks and work environments differ significantly.

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

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

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

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

Infographic showing various Remote Utilization Review Nurse Practitioner job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $130,618 per year, or $62.8 per hour.

RN Clinical Nurse II - Nurse Connect

UNC HEALTH

Chapel Hill, NC โ€ข On-site, Remote

$33.88 - $47.91/hr

Full-time

Re-posted 8 days ago


Job description

This position is Remote. Please review our list of eligible remote work states before applying list of eligible remote work states
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.
* Prefer candidates with 10+ years of RN experience; critical care or ED experience a plus or equivalent direct bedside med-surge experience.
Summary:
Provides competent clinical nursing care consistent with professional standards. Reporting and accountable to the Nurse Manager/Director, the Clinical Nurse is responsible for coordinating and delivering patient care utilizing the nursing process in a hospital setting.
Responsibilities:
1. Education - Participates in identifying and meeting learning needs of self. Attends education programs based on identified learning needs. With assistance, uses patient education materials relevant to patient population. Assesses readiness to learn of the patient/family/caregivers. Assesses developmental level of patient and factors affecting ability to learn.
2. Evaluation of Care - Identifies expected patient outcomes. Seeks guidance as needed in revision of plan of care. Participates in discussion with members of the interdisciplinary team in evaluation of patient care. Communicates relevant information to promote continuity of care.
3. Implementation - Demonstrates competence in care of patients with complex problems, including population-appropriate physical, psychosocial, educational and safety aspects of care. Performs bedside point of care testing as required for patient care plan. Utilizes healthcare organization and nursing standards, policies and procedures in delivery of care. Organizes and prioritizes care according to patient/family needs. Consults with appropriate resources in a timely fashion regarding patients with complex care issues, unusual teaching needs and/or those at high risk for discharge planning.
4. Leadership - With assistance, develops goals to promote professional growth or minimize limitations. Achieves goals and objectives within identified time frame or renegotiates with supervisor. Is knowledgeable about activities which facilitate intra/interdepartmental collaboration. Participates in development and achievement of unit goals and performance improvement activities. Effectively uses communication systems. Participates in promoting cost-effective care. Gives feedback to co-workers. Is aware of public policy and regulatory guidelines affecting the health care environment. Promotes a safe, clean and secure hospital environment for all.
5. Patient Assessment - Recognizes data from complex situations to determine priorities for care. Includes appropriate physical, psychosocial, education and safety needs. Synthesizes assessment data into meaningful whole prior to communication to others. Assesses and anticipates discharge needs of individual patients and families. Develops relationships with families that promote their ability to advocate for the patient and their own needs.
6. Planning - Collaborates with patient/family to prepare or update the plan of care. Makes use of available multidisciplinary resources in planning care. Begins to use full range of communication as a means to convey planning. Identifies and addresses cultural and ethnic issues in planning patient care. Demonstrates ability to prioritize tasks for patients with complex problems.
7. Research - Reads journals that contain studies or articles that may be applicable to practice. Brings ideas and questions to the staff at large for assessment of applicability.
Other Information
Other information:
Education Requirements:
โ€ข Graduation from a school of professional nursing.
โ€ข If hired after January 6, 2014, must be enrolled within four years of employment, and obtain a Bachelor's degree with a major in Nursing or a Master's degree with a major in Nursing within seven years of employment date.
Licensure/Certification Requirements:
โ€ข Licensed to practice as a Registered Nurse in the state of North Carolina.
โ€ข Basic Life Support (BLS) for Healthcare Provider certification
Professional Experience Requirements:
โ€ข One (1) year of nursing experience.
Knowledge/Skills/and Abilities Requirements:
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Nurse Connect
Work Type: Full Time
Standard Hours Per Week: 30.00
Salary Range: $33.88 - $47.91 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Remote
Work Schedule: Variable
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.