ZipRecruiter

Log In

1

Utilization Management Auditor Jobs in Raleigh, NC

Azurity Pharmaceuticals - US

Controller

Raleigh, NC · Hybrid

... utilization trends, and true‑ups. * Partner with Commercial, Managed Markets, and Contracting ... Serve as the primary US accounting contact for external auditors. * Lead audit planning ...

Azurity Pharmaceuticals - US

Controller

Raleigh, NC · On-site

... analysis, utilization trends, and true-ups. * Partner with Commercial, Managed Markets, and ... Serve as the primary US accounting contact for external auditors. * Lead audit planning ...

CBRE

Sr. Maintenance Manager

Garner, NC · On-site

Looking for a rewarding career in Management? Read on to learn more! About the Role In this role ... auditing, and assessment, etc. * Monitor appropriate staffing levels and reports on utilization and ...

Clever Devices Ltd.

Customer Success Manager

Apex, NC · On-site

$90K - $130K/yr

... data, activity, utilization, trends, analysis, health, status, risks, and recommendations ... Proactive management of operational runbook for assigned accounts * Auditing the performance of the ...

DPR Construction

EHS Application Admin

Raleigh, NC · On-site

Application deployment concepts including utilization of multiple application or system ... least privilege, auditing, logging, and permissions management. * Information Technology ...

GFL Environmental

Benefits Administrator

Raleigh, NC · On-site

Manage day-to-day operations of US group benefits programs, including medical, dental, vision ... Compile tracking, utilization, and compliance reports as needed. What We're Looking For ...

GFL Environmental

Benefits Administrator

Raleigh, NC · Remote

Manage day-to-day operations of US groupbenefits programs, including medical, dental, vision, short ... Compile tracking, utilization, and compliance reports as needed. What We're Looking For ...

Conti Civil

Project Accountant

Raleigh, NC · On-site

$59K - $77K/yr

... and management, subcontractor invoicing, change orders, compliance auditing, and financial ... Reviews the weekly equipment charges and utilization reports. Discusses any variances with the ...

next page

Showing results 1-20

All JobsUtilization Management Auditor JobsUtilization Management Auditor Jobs in Raleigh, NC

Utilization Management Auditor information

See Raleigh, NC salary details

$15

$31

$52

How much do utilization management auditor jobs pay per hour?

As of Jul 20, 2026, the average hourly pay for utilization management auditor in Raleigh, NC is $31.05, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $39.47 per hour, depending on experience, location, and employer.

What is the highest paying job in healthcare management?

In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to be the highest paying positions, often earning six-figure salaries. These roles require extensive experience, leadership skills, and often advanced degrees or certifications, and they oversee large healthcare organizations or systems.

Is a night auditor an entry level position?

A night auditor is typically an entry-level position in the hospitality industry, often suitable for individuals with basic customer service skills and some accounting knowledge. The role involves overnight shifts, reconciling accounts, and handling guest inquiries, and some employers may require prior experience or certifications in hospitality or accounting. However, the specific requirements can vary by employer and location.

What is the difference between Utilization Management Auditor vs Utilization Review Nurse?

AspectUtilization Management AuditorUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications like CCM or CUCLicensed Registered Nurse (RN), often with additional certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinics, insurance companies, often in clinical settings
Primary FocusAuditing and reviewing utilization data for compliance and cost managementAssessing patient care needs and determining appropriate services

While both roles involve healthcare utilization, the Utilization Management Auditor primarily reviews data for compliance and cost efficiency, whereas the Utilization Review Nurse focuses on patient care assessments. Both require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ.

What are some common challenges faced by Utilization Management Auditors and how can they be addressed?

Utilization Management Auditors often encounter challenges such as keeping up with constantly changing healthcare regulations and payer requirements, interpreting complex medical documentation, and ensuring compliance with both internal and external policies. To address these challenges, auditors should engage in ongoing professional development, collaborate closely with clinical and administrative teams for accurate information, and make use of robust audit tools and resources. Effective communication and a proactive approach to regulatory changes can help streamline the audit process and maintain high standards of accuracy.

What is a Utilization Management Auditor?

A Utilization Management Auditor is a healthcare professional responsible for reviewing medical records, claims, and utilization data to ensure that healthcare services provided to patients are necessary, appropriate, and comply with established guidelines and policies. They help identify overuse, underuse, or misuse of medical resources and ensure regulatory compliance. Utilization Management Auditors work closely with healthcare providers, insurance companies, and regulatory agencies to improve the quality and cost-effectiveness of patient care.

Will AI take utilization management jobs?

Utilization Management Auditors perform reviews of healthcare services to ensure appropriate and efficient care. While AI tools can assist with data analysis and streamline certain tasks, the role requires critical thinking, clinical judgment, and regulatory knowledge that are not fully replaceable by AI at this time.

Is an auditor a high paying job?

Utilization Management Auditors typically earn salaries that are competitive within the healthcare and insurance industries, with pay varying based on experience, location, and certifications. While some auditing roles offer high salaries, they generally do not reach the highest pay levels compared to specialized or executive positions, but they can provide stable and rewarding careers for those with relevant skills and certifications. Factors such as industry demand and professional credentials influence earning potential.

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

To thrive as a Utilization Management Auditor, you need a strong background in healthcare administration, case management, and medical coding, often supported by a clinical degree or certification such as RN, LPN, or RHIA. Familiarity with utilization management software, electronic health records (EHRs), and regulatory standards like CMS guidelines is essential. Analytical thinking, attention to detail, and effective communication are crucial soft skills for identifying compliance issues and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and optimal resource utilization within healthcare organizations.
What are popular job titles related to Utilization Management Auditor jobs in Raleigh, NC? For Utilization Management Auditor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Utilization Management Auditor jobs in Raleigh, NC look for? The top searched job categories for Utilization Management Auditor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Utilization Management Auditor jobs? Cities near Raleigh, NC with the most Utilization Management Auditor job openings:
Utilization Management Auditor jobs near you

Controller

Azurity Pharmaceuticals - US

Raleigh, NC • Hybrid

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 22 days ago

Job description

Azurity Pharmaceuticals is a privately held, specialty pharmaceutical company that focuses on innovative products that meet the needs of underserved patients. As an industry leader in providing unique, accessible, and high-quality medications, Azurity leverages its integrated capabilities and vast partner network to continually expand its broad commercial product portfolio and robust late-stage pipeline. The company's patient-centric products span the cardiovascular, neurology, endocrinology, gastro-intestinal, institutional, and orphan markets, and have benefited millions of patients. For more information, visit www.azurity.com.

Azurity Pharmaceuticals is proud to be an inclusive workplace and an Equal Opportunity Employer. Azurity's success is attributable to our incredibly talented, dedicated team that focuses on benefiting the lives of patients by bringing the best science and commitment to quality into everything that we do. We seek highly motivated individuals with the dedication, integrity, and creative spirit needed to thrive in our organization.

About the Role

Role Summary

The Director, US Controller provides senior‑level oversight of US accounting, financial reporting, and Gross‑to‑Net (GTN) accounting, delivered through a Global Capability Center (GCC). This role is accountable for the quality, accuracy, and GAAP compliance of the US close, while day‑to‑day execution is performed by the GCC.

The Director serves as the primary US accounting authority, owning accounting policy, technical judgment, review, and audit interaction. The role partners closely with Commercial, FP&A, Contracting, and External Auditors to ensure reliable, decision‑ready financials in a GTN‑intensive commercial environment.

Key Responsibilities

US Close & Financial Reporting Oversight

  • Provide overall governance and oversight of the US monthly, quarterly, and annual close executed by the GCC.
  • Own the close calendar, review framework, and escalation process.
  • Review and approve all material journal entries, estimates, and balance sheet reconciliations.
  • Ensure timely delivery of accurate US GAAP financial statements and management reporting.
  • Serve as final accounting approver prior to submission to senior leadership and auditors.

Gross‑to‑Net Accounting Leadership

  • Own GTN accounting policy, methodology, and estimation framework.
  • Review and challenge GTN reserve calculations prepared by the GCC, including:
    • Chargebacks
    • Commercial and government rebates
    • Returns and return reserves
    • Admin/service fees, distribution fees, prompt pay, and other deductions
  • Apply accounting judgment to assumptions, lag analysis, utilization trends, and true‑ups.
  • Partner with Commercial, Managed Markets, and Contracting teams to ensure GTN accounting reflects contractual reality.
  • Explain GTN movements, risks, and volatility drivers to FP&A and senior finance leadership.

GCC Governance & Quality Control

  • Act as the primary onshore accounting oversight lead for the GCC‑supported US close.
  • Define clear roles, review standards, and documentation expectations.
  • Conduct structured reviews of GCC output to ensure consistency, accuracy, and GAAP compliance.
  • Identify quality or control issues and work with GCC leadership to remediate.
  • Escalate and resolve complex accounting matters requiring onshore judgment.

Controls, Audit & Policy

  • Own US accounting policies, technical memos, and key accounting judgments.
  • Ensure GCC‑executed processes are well‑documented, controlled, and audit‑ready.
  • Serve as the primary US accounting contact for external auditors.
  • Lead audit planning, walkthroughs, technical discussions, and issue resolution.

Required Qualifications

  • Bachelor's degree in Accounting or Finance; CPA.
  • 12+ years of progressive accounting experience, including Controller or Director‑level roles.
  • Deep Gross‑to‑Net accounting experience, ideally in pharma or life sciences.
  • Experience operating within a GCC or offshore‑supported accounting model.
  • Strong US GAAP knowledge with demonstrated judgment in revenue, estimates, and reserves.
  • Proven strength in review, governance, and stakeholder management rather than transaction execution.

Leadership Profile

  • Senior accounting reviewer and technical authority
  • Comfortable challenging assumptions and outputs
  • Clear communicator with executives and auditors
  • Strong governance and quality mindset
  • Effective influencer across onshore and offshore teams

What Success Looks Like

  • Consistent, high‑quality US close delivered through the GCC
  • Defensible, explainable GTN reserves with minimal surprises
  • Smooth audits with strong documentation and limited rework
  • High trust from Commercial, FP&A, and Finance leadership

#LI-Hybrid
#LI-Full-time

Physical & Mental Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Must be able to sit for long periods of time
  • While performing the duties of this job, the employee is frequently required to stand; walk; sit; talk and/or hear
  • May occasionally climb stairs and/or ride elevators
  • The employee must occasionally lift and/or move up to 25 pounds
  • Employee must be able to manipulate keyboard, operate a telephone and hand-held devices
  • Other miscellaneous job duties as required

Benefits We Offer:

  • Unlock Your Earning Potential: Join our team and be rewarded with a competitive compensation package, including an annual bonus based on company performance, that recognizes your exceptional talent.
    • Sales - In lieu of annual bonuses, we offer an Incentive compensation program that allows you to earn more - even over plan.
    • Fuel Your Success: *Sales Only* - We understand the value of your hard work and provide a car reimbursement program and gas card for both business and personal use as part of our commitment to supporting you.
  • Comprehensive Health Coverage: We value your well-being and offer excellent medical, dental, vision, and prescription coverage to ensure you and your family are always taken care of.
  • Flexibility for Your Lifestyle: Achieve work-life balance with our hybrid work model, allowing you to work two days from home and three days in the office. *Excludes Sales, Manufacturing, and some Operations positions*
  • Invest in Your Future: Our Retirement Savings Plan (401K) is designed to help you secure a comfortable retirement by matching dollar for dollar up to 5%.
  • Time Off That Counts: Take advantage of our generous time off policy, which offers up to 15 vacation days annually + rollover (up to 40 hours) as well as five sick/wellness days. For new employees, vacation accrual will be prorated based on your start date.
  • Meaningful Time with Your Loved Ones: We close between Christmas and New Year's to give you an extra week off to spend quality time with your family and recharge.
  • Enjoy the Holidays: Over the course of the year, Azurity recognizes 13 holidays.
  • Invest in Your Education: We support your professional growth with tuition reimbursement for undergraduate and graduate level courses or certifications.
  • Recognize and Be Recognized: Our Azurity High Five peer recognition platform allows you to celebrate your colleagues' accomplishments and receive recognition for your own outstanding work.

The California Consumer Privacy Act regulates privacy rights and consumer protection for residents of California, United States. For details, click here.

The General Data Protection Regulation (GDPR) sets guidelines for the collection and processing of personal information from individuals who live in the European Union (EU).