Raleigh, NC · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Many DUR roles offer hybrid or fully remote schedules. * Rewards: Competitive salary, benefits, and ...
Raleigh, NC · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Many DUR roles offer hybrid or fully remote schedules. * Rewards: Competitive salary, benefits, and ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... Identify over/under utilization patterns and participate in analysis of practice patterns * Review ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... Identify over/under utilization patterns and participate in analysis of practice patterns * Review ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... Identify over/under utilization patterns and participate in analysis of practice patterns * Review ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... Identify over/under utilization patterns and participate in analysis of practice patterns * Review ...
Raleigh, NC · Remote
$52 - $62.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Raleigh, NC · Remote
$52 - $62.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Raleigh, NC · On-site +1
$51 - $62.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Raleigh, NC · On-site +1
$51 - $62.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
The Analyst will create and manage reports that monitor care utilization, premium, and MLR. The ... For further information, please review the Know Your Rights notice from the Department of Labor.
The Analyst will create and manage reports that monitor care utilization, premium, and MLR. The ... For further information, please review the Know Your Rights notice from the Department of Labor.
... to utilization of outside counsel. This position is full-time remote. Selected candidate must ... Review and determine the merits of a case; develop a case strategy, perform research to prepare for ...
... to utilization of outside counsel. This position is full-time remote. Selected candidate must ... Review and determine the merits of a case; develop a case strategy, perform research to prepare for ...
Review policies * As appropriate, market, negotiate, prepare and analyze alternative renewal ... Follow established agency procedures for effective utilization of agency management system * Take ...
Review policies * As appropriate, market, negotiate, prepare and analyze alternative renewal ... Follow established agency procedures for effective utilization of agency management system * Take ...
Drive accountability through routine performance scorecards, operational reviews, and metric-based ... utilization, revenue cycle performance, and cost structures. * Mentor and support operational ...
Drive accountability through routine performance scorecards, operational reviews, and metric-based ... utilization, revenue cycle performance, and cost structures. * Mentor and support operational ...
It will also help pioneer the build-out and utilization of a proprietary battery storage / energy ... reviewing and making recommendations on commercial agreements (PPA, O&M, Transmission ...
It will also help pioneer the build-out and utilization of a proprietary battery storage / energy ... reviewing and making recommendations on commercial agreements (PPA, O&M, Transmission ...
Chapel Hill, NC · Remote
$155K - $196K/yr
... review criteria: need analysis, financial feasibility, utilization projections, and service area ... Remote (USA-based; must be available during Eastern core hours 8:30 AM - 5:30 PM ET) * Travel ...
Chapel Hill, NC · Remote
$155K - $196K/yr
... review criteria: need analysis, financial feasibility, utilization projections, and service area ... Remote (USA-based; must be available during Eastern core hours 8:30 AM - 5:30 PM ET) * Travel ...
... review criteria: need analysis, financial feasibility, utilization projections, and service area ... Remote (USA-based; must be available during Eastern core hours 8:30 AM 5:30 PM ET) * Travel ...
Quick apply
... review criteria: need analysis, financial feasibility, utilization projections, and service area ... Remote (USA-based; must be available during Eastern core hours 8:30 AM 5:30 PM ET) * Travel ...
It will also help pioneer the build\-out and utilization of a proprietary battery storage \/ energy ... reviewing and making recommendations on commercial agreements (PPA, O&M, Transmission ...
It will also help pioneer the build\-out and utilization of a proprietary battery storage \/ energy ... reviewing and making recommendations on commercial agreements (PPA, O&M, Transmission ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$55 - $66/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$52.75 - $63.50/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · On-site +1
$52.75 - $63.50/hr
S. office in Research Triangle Park, NC, or may be considered for fully remote work from an ... Help design, conduct, and interpret studies to understand drug utilization patterns overall and in ...
Durham, NC · Remote
... Remote services/monitoring, Backup maintenance, EndPoint Hardware/Software, Wireless infrastructures, Vendor management. HeavySecurity emphasis. Collect/review network utilization reports: Debug ...
Durham, NC · Remote
... Remote services/monitoring, Backup maintenance, EndPoint Hardware/Software, Wireless infrastructures, Vendor management. HeavySecurity emphasis. Collect/review network utilization reports: Debug ...
Home-based remote working opportunities. * Work/life balance as well as flexible schedules ... Reviews and provides relevant epidemiological input to statistical analysis plans and analysis ...
Home-based remote working opportunities. * Work/life balance as well as flexible schedules ... Reviews and provides relevant epidemiological input to statistical analysis plans and analysis ...
Raleigh, NC · On-site +1
Drive market share through existing customer utilization assessments and contending for new ... Routinely update sales actions plans and forecasts for Territory Quarterly Reviews and Business ...
Raleigh, NC · On-site +1
Drive market share through existing customer utilization assessments and contending for new ... Routinely update sales actions plans and forecasts for Territory Quarterly Reviews and Business ...
$20.80 - $25
2% of jobs
$25 - $29.21
9% of jobs
$32.09 is the 25th percentile. Wages below this are outliers.
$29.21 - $33.42
21% of jobs
The median wage is $36.82 / hr.
$33.42 - $37.62
23% of jobs
$37.62 - $41.83
13% of jobs
$45.10 is the 75th percentile. Wages above this are outliers.
$41.83 - $46.03
10% of jobs
$46.03 - $50.24
8% of jobs
$50.24 - $54.45
5% of jobs
$54.45 - $58.65
5% of jobs
$58.65 - $62.86
2% of jobs
$62.86 - $67.06
2% of jobs
$20
$41
$67
To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.
A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.
A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.
Other
Medical
Posted 23 days ago
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications
A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for pharmacists who enjoy analyzing medication use, applying clinical guidelines, and collaborating with providers to promote safe, cost-effective care.
Key Responsibilities
What You'll Bring
Why This Role?
About Us
We are a confidential healthcare partner providing managed care pharmacy services nationwide. Our DUR pharmacists play a key role in ensuring that medications are used safely, appropriately, and cost-effectively across diverse patient populations.
Apply Today
Advance your career in managed care pharmacy - apply now for our Drug Utilization Review Pharmacist opening and help lead the way in improving medication safety and outcomes.
