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Utilization Management Assistant Jobs in Raleigh, NC

Perform weekly review of direct report billable hours and associated utilization against the budget, escalate outliers and assist the management team with mitigation. * Assess available resources, in ...

... utilization and overall engagement efficiency Supervise the audit and tax preparation process ... an ongoing basis Assist with sourcing new clients, issuing proposals and overall business ...

Conducts peer-to-peer consultation with ordering physicians, physician assistants and advanced ... Experience with utilization management, especially with CMS guidelines preferred. * Preferred board ...

... needs, staff utilization and overall engagement efficiency • Supervise the audit and tax ... ongoing basis • Assist with sourcing new clients, issuing proposals and overall business ...

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Utilization Management Assistant information

See Raleigh, NC salary details

$28.2K

$47K

$67.6K

How much do utilization management assistant jobs pay per year?

As of Jun 10, 2026, the average yearly pay for utilization management assistant in Raleigh, NC is $47,045.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,800.00 and $47,100.00 per year, depending on experience, location, and employer.

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

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges Utilization Management Assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a Utilization Management Assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.
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 cities near Raleigh, NC are hiring for Utilization Management Assistant jobs? Cities near Raleigh, NC with the most Utilization Management Assistant job openings:

Manager, Site Readiness - FSO

Fortrea

Durham, NC

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago


Fortrea rating

7.2

Company rating: 7.2 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

45th of 57 rated research


Job description

Fortrea's Full Service Team is hiring a Assoc Mgr/Manager, Site Readiness! This role is remote based in the US.

Job Overview:

The Manager, Start-up Operations is accountable for delivering on-time, high quality study start-up and maintenance activities within a country, or country cluster, as well as for central/local IEC/IRB submission, document collection, update of relevant systems and filing. This role will lead a startup team within a country or a cluster of countries that will work to activate study sites and ensure the filing of documentation into the eTMF system and completion of CTMS from the start to the end of the start-up period, including maintenance throughout the cycle of the study. The Manager, Startup Operations will also have direct line management responsibility for the start-up operations team in their country or a cluster of countries and oversight of all country-level client deliverables and timelines of start-up at the country and site levels. The Manager, Start-up Operations will act as a local point of contact for activities around start-up deliverables in the country. The Manager, Start-up Operations will have operational detailed oversight, ensuring right commitments and right timelines are met. The Manager, Start-up Operations will be the first line of escalation for performance issues and quality concerns and will have the necessary overview to confirm country start-up stays on track. This role will serve as the local Subject Matter Experts (SME) for start-up processes including timelines, training, and development of the start-up team at the local level and on local regulations. Has accountability for quality, performance and GCP compliance for start-up operations staff. Has accountability for delivery of all country level start-up deliverables and timelines. Has accountability for legal and regulatory requirement compliance for study activation and may include maintenance. Has line management responsibility for all start-up staff in country or in cluster of countries. Has recruitment, allocations, coaching, trainings, and talent development responsibility for Start-up operational (SU Ops) staff. Is responsible for resource and utilization management of start-up operations staff. May act as local contact for business development/client relations, works closely with strategic clients and ensures client satisfaction. Can be involved in local vendor management (sub-CRO and suppliers). May have additional line management assignment.

Summary of Responsibilities:

  • Accountable to deliver start-up, maintenance and document filing in country on time and within study budget.
  • Ensure quality and completeness of relevant systems for country and cluster.
  • Look for opportunities to continuously improve country study start-up processes, cycle time and accuracy of projections (say/do ratio of 80% and above).
  • Implement local lessons learnt to accelerate timelines.
  • Resource allocation and line management of start-up operations staff in country or country clusters.
  • Ensure cross-departmental collaboration and communication to ensure client satisfaction.
  • Training and coaching of local resources on SOPs and company procedures.
  • Ensure training record compliance with training matrix and training records are up-to- date.
  • Act as primary point of contact (POC) for escalations.
  • Have GCP oversight of direct reports by ensuring GCPs are understood and implemented.
  • Contribute to "at risk" sites identification within the QC risk assessment.
  • Provide input to relevant SOPs and standard plans/templates for use by start-up staff.
  • Assist with coordination and implementation of on-boarding new direct reports ensuring GCP and local regulations training before work begins.
  • Hold staff accountable for GCP issue escalation to the management team, the sponsor and QA, as appropriate and determine regional implications for corrective action plans.
  • Hold staff accountable for compliance with project plan and adherence to contract obligations in quality, forecast for start-up and on time deliverables.
  • Coach staff to own effective investigator relations and investigator oversight.
  • When appropriate, acts as contact for local regulatory authorities on start-up issues in collaboration with the Country Head and Global Regulatory Submissions.
  • Productivity/Financial Management for the Start-up team - In support of the Country Head:
  • Communicate status of assigned workload for metric reporting.
  • Perform weekly review of direct report billable hours and associated utilization against the budget, escalate outliers and assist the management team with mitigation.
  • Assess available resources, in context of project allocation, supply and demand, to resourcing team.
  • Engage in resource management activities for direct reports or across a project team.
  • Accountable for expense management, expense report approval and compliance with Travel Policy of direct reports.
  • May act as Manager, Start-up Operations for other countries besides the one-off residence.
  • May serve as the Start-up Country Head.
  • May manage start-up activities conducted by a sub-CRO(s) of relevant country.
  • Local Regulatory Expert:
  • Supports the Global Regulatory Submissions group and Project Team in managing local regulatory issues.
  • Assures accountability for legal and regulatory requirement compliance through working with/employing local regulatory experts.
  • Helps to ensure that new country regulatory information and changes to local drug law, legal regulations and EC/CA specific requirements are communicated to local and international staff.
  • Note - In countries where Global Regulatory Submissions reside, the expertise and regulatory contact with the Competent Authorities may be a GRS representative.
  • Study Start-Up and Maintenance:
  • Providing detailed day to day operational oversight of the in-country startup team, deliverables and timelines to ensure timelines for site activation are achieved.
  • Ensuring clear assumptions and country level requirements are provided with timeline commitments.
  • Pressure testing the in-country teams on delivery, quality, commitments and status to ensure on time delivery.
  • Review and sign off on initial start-up timelines for awarded work and any re-baselined timelines required.
  • Proactively escalating risks before issues arise.
  • Removing country/site level roadblocks
  • Ensuring sufficient staff levels and competency to complete start-up tasks to plan
  • Coaching and mentoring staff on how to set local timelines, how to engage sites and to deal with sites directly.
  • Acting as Country SME for start-up
  • All other duties as needed or assigned.

Qualifications (Minimum Required):

  • University/college degree - life sciences preferred or certification in a related allied health profession from an appropriately accredited institution (e.g., nursing certification, medical or laboratory technology).
  • In lieu of this required educational background the following relevant work history may be considered:
  • Minimum of three (3) years supervisory experience in a health care or clinical research setting and
  • Minimum of seven (7) years relevant clinical research experience in a pharmaceutical company/CRO.
  • Fortrea may consider relevant and equivalent experience in lieu of educational requirements.
  • Preferred:
  • Master's or other advanced degree.

Experience (Minimum Required):

  • Years of experience in the job discipline:
  • 3 years supervisory experience.
  • Years of experience in other professional roles:
  • 7 years clinical research experience.
  • Relevant supervisory experience; Demonstrated ability to lead by example and to encourage team members to seek solutions.
  • Proven interpersonal skills.
  • Demonstrated ability to successfully participate as a member of a project team.
  • Demonstrated ability to successfully manage multiple competing priorities; Advanced planning and organizational skills.
  • Advanced oral, written and presentation skills.

What do you get?

Regular, full-time or part-time employees working 20 or more hours per week are eligible for comprehensive benefits including but not limited to:
  • Medical, Dental, Vision, Life, STD/LTD (multiple insurance carriers)
  • 401(K)
  • Paid time off (PTO) - Flex Plan
  • Employee recognition awards
  • Multiple ERG's (employee resource groups)
  • Target Pay Range based on title: $110-125K

Work Environment:

  • Work is performed in an office environment with exposure to electrical office equipment.
  • Frequent travel to clients/ site locations with occasional travel both domestic and international.

Physical Requirements:

  • Ability to sit for extended periods and operate a vehicle safely.
  • Repetitive hand movement of both hands with the ability to make fast, simple, repeated movements of the fingers, hands, and wrists.
  • Occasional crouching, stooping, with frequent bending and twisting of upper body and neck.
  • Ability to access and use a variety of computer software developed both in-house and off-the-shelf.
  • Light to moderate lifting and carrying (or otherwise moves) objects including luggage and laptop computer with a maximum lift of 15-20 lbs.
  • Regular and consistent attendance.
  • Varied hours may be required.

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