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Rn Utilization Management Jobs in Raleigh, NC (NOW HIRING)

Telehealth Nurse

Cary, NC ยท On-site

$30.75 - $40.75/hr

Telehealth Oncology Registered Nurse This telehealth oncology nursing role focuses on counseling ... Experience in telehealth, triage, or utilization management in a clinical setting. * Oncology ...

Telehealth Nurse

Cary, NC

$29.75 - $39.25/hr

Telehealth Oncology Registered Nurse This telehealth oncology nursing role focuses on counseling ... Experience in telehealth, triage, or utilization management in a clinical setting. * Oncology ...

Registered Nurse In Home Health Explore opportunities with Suncrest Home Health, a part of LHC ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Registered Nurse In Home Health Explore opportunities with Suncrest Home Health, a part of LHC ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Registered Nurse - RN

Durham, NC ยท On-site

$45.71 - $68.56/hr

Registered Nurse In Home Health Explore opportunities with Suncrest Home Health, a part of LHC ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Showing results 41-60

Rn Utilization Management information

See Raleigh, NC salary details

$37.9K

$87K

$158.4K

How much do rn utilization management jobs pay per year?

As of Aug 11, 2026, the average yearly pay for rn utilization management in Raleigh, NC is $86,984.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,700.00 and $101,600.00 per year, depending on experience, location, and employer.

How does an RN Utilization Management typically collaborate with physicians and other healthcare team members?

RN Utilization Management professionals work closely with physicians, case managers, and insurance representatives to ensure patients receive appropriate, high-quality care while managing healthcare costs. They review patient records, communicate clinical findings, and may participate in interdisciplinary meetings to discuss care plans and discharge needs. Building strong relationships and maintaining open lines of communication with the care team is essential for timely authorizations and effective care coordination. This collaborative approach helps optimize patient outcomes and resource utilization.

What skills and qualifications are needed to thrive as an RN Utilization Management?

To thrive as an RN Utilization Management Nurse, you need a current RN license, strong clinical assessment skills, and experience in care coordination or case management. Familiarity with utilization review tools, electronic health records, and knowledge of insurance guidelines or InterQual/MCG criteria are typically required. Exceptional communication, critical thinking, and negotiation skills help facilitate collaboration among providers, payers, and patients. These abilities are crucial for ensuring appropriate resource use, compliance with regulations, and optimal patient outcomes.

How to get into utilization management as an RN?

To become an RN in utilization management, gain experience as a registered nurse, often in case management or clinical roles, and obtain knowledge of insurance policies and healthcare regulations. Certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ) can enhance prospects. Strong communication skills and familiarity with electronic health records (EHR) systems are also beneficial.

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

AspectRn Utilization ManagementRn Case Management
CertificationsRN license, possibly certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentUtilization review departments, insurance companies, hospitalsCommunity clinics, hospitals, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Both roles require an RN license, but Rn Utilization Management focuses on reviewing the necessity of services, while Rn Case Management emphasizes coordinating patient care. Understanding these differences helps professionals choose the right career path and employers.

What does a utilization management registered nurse do?

A utilization management registered nurse reviews patient cases to determine the necessity, appropriateness, and efficiency of healthcare services and treatments. They analyze medical records, collaborate with healthcare providers, and ensure compliance with insurance and regulatory guidelines, often using electronic health records and clinical judgment. Certification in case management or utilization review is commonly required for this role.

What is an RN Utilization Management?

RN Utilization Management nurses are registered nurses who specialize in reviewing healthcare services to ensure patients receive appropriate and cost-effective care. They evaluate the necessity, efficiency, and quality of medical treatments and procedures, often working with insurance companies, hospitals, or healthcare organizations. Their responsibilities include reviewing patient records, coordinating with clinical staff, making coverage recommendations, and ensuring compliance with healthcare regulations. This role helps manage healthcare costs while maintaining high standards of patient care.
What are popular job titles related to Rn Utilization Management jobs in Raleigh, NC? For Rn Utilization Management jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Rn Utilization Management jobs in Raleigh, NC look for? The top searched job categories for Rn Utilization Management jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Rn Utilization Management jobs? Cities near Raleigh, NC with the most Rn Utilization Management job openings:
Infographic showing various Rn Utilization Management job openings in Raleigh, NC as of August 2026, with employment types broken down into 2% As Needed, 77% Full Time, 14% Part Time, 2% Temporary, and 5% Contract. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $86,984 per year, or $41.8 per hour.

Telehealth Nurse

Actalent

Cary, NC โ€ข On-site

$30.75 - $40.75/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago


Job description

Job Title: Telehealth Oncology Registered Nurse

Job Description

This telehealth oncology nursing role focuses on counseling and educating oncology patients about specialty drug therapies over the phone, with no direct patient care or home visits. You provide expert guidance on treatment plans, side effects, and therapy adherence while maintaining strict compliance with contracted and accrediting regulations. Using electronic medical records (EMR), you document all patient interactions thoroughly and accurately in line with industry standards and regulatory requirements. This position offers the opportunity to contribute to patient care and access within a large healthcare organization, supporting individuals undergoing complex oncology and hematology treatments.

Responsibilities

  • Counsel and educate new and existing oncology patients on specialty drug therapies via inbound and outbound telephone calls.

  • Explain treatment plans and medication regimens clearly to support understanding and adherence to prescribed therapies.

  • Discuss potential and current side effects with patients, providing education on treatment alternatives and strategies to facilitate ongoing therapy adherence.

  • Identify, document, and report adverse events and product complaints to the appropriate manufacturer, the FDA, and other governing authorities in accordance with regulatory requirements.

  • Ensure adherence to contracted and accrediting regulations as indicated by drug specifications and applicable standards.

  • Complete thorough, accurate, and timely documentation of all patient interactions using EMR systems, following good documentation practices and industry compliance standards.

  • Apply telehealth and triage skills to assess patient concerns and determine appropriate next steps or escalation pathways.

  • Utilize oncology nursing knowledge to provide clinically sound education and support for patients receiving oncology and hematology therapies.

  • Use strong computer skills to manage email, word processing, spreadsheets, and web-based programs required for patient care and documentation.

  • Communicate effectively with patients and colleagues both orally and in writing, using techniques such as motivational interviewing to support behavior change and treatment adherence.

  • Read, analyze, and interpret practice standards, professional journals, technical procedures, and government standards and regulations relevant to oncology drug therapies and telehealth practice.

Essential Skills

  • Registered Nurse (RN) with a current unrestricted multi-state compact state license, including North Carolina.

  • 3+ years of nursing experience, with at least 1 year of acute, inpatient care experience preferred.

  • Experience in telehealth, triage, or utilization management in a clinical setting.

  • Oncology nursing or oncology and/or hematology experience preferred.

  • Strong patient education skills, particularly related to specialty drug therapies and side-effect management.

  • Proficiency with electronic medical record (EMR) systems and adherence to good documentation practices.

  • Strong computer skills, including use of email, word processing, spreadsheet, and web-based programs.

  • Effective oral and written communication skills, including the ability to explain complex clinical information in a clear and empathetic manner.

  • Ability to read, analyze, and interpret practice standards, professional journals, technical procedures, and government standards and regulations.

  • Attention to detail and commitment to regulatory compliance when identifying and reporting adverse events and product complaints.

Additional Skills & Qualifications

  • Oncology and/or hematology nursing experience, particularly in patient education and telehealth, is highly desirable.

  • Experience with motivational interviewing techniques to support patient engagement and adherence to therapy.

  • Experience in acute care, inpatient nursing, or triage is beneficial for assessing patient needs in a telehealth environment.

  • Familiarity with utilization management processes in healthcare settings.

  • Comfort working within a large healthcare organization focused on patient care and access.

  • Ability to work independently while collaborating effectively with interdisciplinary healthcare teams.

Work Environment

This role is based in an onsite clinical telehealth environment with a structured schedule. The standard work hours are Monday through Friday from 9:00 a.m. to 6:00 p.m., with occasional Saturday shifts on a quarterly rotation that may be performed remotely. You primarily interact with patients via telephone, using telehealth technologies and electronic medical record systems to support care delivery and documentation. The environment emphasizes regulatory compliance, accurate record keeping, and consistent patient access, with a professional, office-based setting aligned to a large healthcare organization's standards.

Job Type & Location

This is a Contract to Hire position based out of Cary, NC.

Pay and Benefits

The pay range for this position is $41.00 - $41.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Cary,NC.

Application Deadline

This position is anticipated to close on Aug 14, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffingยฎ winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.


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About Actalent

Sourced by ZipRecruiter

Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We're supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.

Company size

5,001 - 10,000 Employees

Headquarters location

Hanover, MD, US

Year founded

1983

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