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Senior Occupational Therapy Utilization Review Jobs in Raleigh, NC

Hydro Recruiting

Senior Occupational Therapist

Durham, NC · On-site

$80K - $85K/yr

Master's degree or higher in Occupational Therapy * Certification by the National Board for Certification in Occupational Therapy (NBCOT) * Licensed Occupational Therapist in the state of North ...

Granville County Schools

Occupational Therapist

Oxford, NC · On-site

$37 - $48.75/hr

... • Reviews occupational therapy services for quality improvement and makes changes as needed to ensure quality of services. Education • Teaches, monitors, and collaborates with educational ...

Central Office

Occupational Therapist

Oxford, NC · On-site

$37 - $48.75/hr

Reviews occupational therapy services for quality improvement and makes changes as needed to ensure quality of services. Education * Teaches, monitors, and collaborates with educational personnel ...

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Senior Occupational Therapy Utilization Review information

See Raleigh, NC salary details

$50.1K

$72.4K

$108.4K

How much do senior occupational therapy utilization review jobs pay per year?

As of Aug 25, 2026, the average yearly pay for senior occupational therapy utilization review in Raleigh, NC is $72,414.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,800.00 and $77,300.00 per year, depending on experience, location, and employer.

What is a senior occupational therapy utilization review?

A Senior Occupational Therapy Utilization Review professional is responsible for evaluating the medical necessity, appropriateness, and efficiency of occupational therapy services. They review patient records, treatment plans, and clinical documentation to ensure compliance with insurance policies and regulatory standards. This role often involves collaborating with therapists, physicians, and insurance companies to determine the best care options while managing costs. Senior reviewers may also mentor junior staff and contribute to policy development within their organization.

How does a senior occupational therapy utilization review specialist typically collaborate with clinicians and case managers to ensure appropriate patient care?

As a Senior Occupational Therapy Utilization Review specialist, you will regularly coordinate with clinicians and case managers to evaluate the medical necessity and appropriateness of occupational therapy services for patients. This involves reviewing clinical documentation, discussing complex cases, and providing education to care teams about coverage criteria and best practices. Collaborating effectively ensures that patients receive timely and necessary therapy while also aligning with payer guidelines. Strong communication and negotiation skills are essential for building positive relationships and facilitating high-quality outcomes.

What are the key skills and qualifications needed to thrive as a senior occupational therapy utilization review specialist, and why are they important?

To thrive as a Senior Occupational Therapy Utilization Review specialist, you need advanced clinical knowledge in occupational therapy, experience in case review, and usually a valid OT license with several years of practice. Familiarity with utilization management software, electronic health records (EHRs), and understanding of insurance guidelines are essential. Excellent analytical thinking, attention to detail, and strong communication skills help in assessing cases and collaborating with providers. Mastering these skills ensures accurate, evidence-based reviews that support quality patient care and compliance with payer policies.

What is the difference between Senior Occupational Therapy Utilization Review vs Occupational Therapist?

AspectSenior Occupational Therapy Utilization ReviewOccupational Therapist
CredentialsLicensed Occupational Therapist, additional experience in utilization reviewLicensed Occupational Therapist
Work EnvironmentUtilization review departments, insurance companies, healthcare organizationsHospitals, clinics, outpatient facilities
Job FocusReviewing medical necessity, insurance authorization, and documentationProviding direct patient care, therapy assessments, treatment planning

The main difference is that Senior Occupational Therapy Utilization Review specialists focus on evaluating treatment necessity and insurance compliance, while Occupational Therapists provide direct patient care and therapy services. The review role emphasizes administrative and evaluative tasks, whereas the therapist role involves hands-on therapy delivery.

What are the most commonly searched types of Occupational Therapy Utilization Review jobs in Raleigh, NC?

The most popular types of Occupational Therapy Utilization Review jobs in Raleigh, NC are:

Senior Occupational Therapy Utilization Review jobs near you

Utilization Review Nurse (RN)

Integrated Resources

Raleigh, NC • On-site

Other

Re-posted 11 days ago

Job description

Utilization Review Nurse (RN)

A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

· The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care.

· Advanced assessment and teaching skills.

· Problem solving skills.

· Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues.

· Utilization and Quality Management/Outcomes experience preferred.

· Previous work experience with a managed care organization or provider is also preferred.

· Prior experience in case management, home health, discharge planning, or Concurrent review.

· RN Diploma, RN Associate's degree or Bachelors of Science in Nursing (BSN) degree.

· Minimum of 3 years clinical experience in an acute medical or acute surgical setting.

· Proficiency with a Microsoft Windows operating system.

· Must have valid license to practice nursing within the US and have started application for NC nursing license.

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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