ZipRecruiter

Log In

1

Utilization Manager Jobs in Raleigh, NC (NOW HIRING)

Axelon

LTSS Service Care Manager

Raleigh, NC · On-site

Hospital CM, Home health, discharge planning, or long-term care experience Home health experience Required Skills: RN and/or LCSW Experience in physical hospital health, care management, utilization ...

previous page

Showing results 41-60

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Raleigh, NC

Utilization Manager information

See Raleigh, NC salary details

$37.9K

$88.5K

$162.8K

How much do utilization manager jobs pay per year?

As of Aug 12, 2026, the average yearly pay for utilization manager in Raleigh, NC is $88,470.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,800.00 and $106,400.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Raleigh, NC? The most popular types of Utilization jobs in Raleigh, NC are:
What are popular job titles related to Utilization Manager jobs in Raleigh, NC? For Utilization Manager jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Raleigh, NC look for? The top searched job categories for Utilization Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Utilization Manager jobs? Cities near Raleigh, NC with the most Utilization Manager job openings:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Raleigh, NC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $88,470 per year, or $42.5 per hour.

Drug Utilization Review (DUR) Pharmacist - Remote

Pharmacy Careers

Raleigh, NC • On-site

Other

Posted yesterday

New

Job description

Remote DUR Pharmacist - Safe & Cost-Effective Medication Use | Work From Home
Analyze medication use patterns, apply clinical guidelines, and collaborate with providers - all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale.
Key Responsibilities

  • Conduct prospective, concurrent, and retrospective drug utilization reviews.
  • Evaluate prescribing patterns against clinical guidelines and formulary criteria.
  • Identify potential drug interactions, therapeutic duplications, and inappropriate therapy.
  • Prepare recommendations for prescribers to optimize therapy and reduce risk.
  • Document reviews and ensure compliance with state, federal, and health-plan requirements.
  • Contribute to quality-improvement initiatives and pharmacy program development.
What You'll Bring
  • Education: PharmD or Bachelor of Pharmacy.
  • Licensure: Active U.S. pharmacist license.
  • Experience: Managed care, PBM, or health-plan preferred. Hospital and community pharmacists with strong clinical skills are encouraged to apply.
  • Skills: Analytical mindset, detail orientation, excellent written and verbal communication.
Why This Role?
  • Shape prescribing decisions that affect thousands of patients.
  • Build expertise in managed care and population-health pharmacy.
  • Many DUR roles offer hybrid or fully remote schedules.
  • Competitive salary, benefits, and career advancement.

About Us
We are a confidential healthcare partner providing managed-care pharmacy services nationwide. Our DUR pharmacists ensure medications are used safely, appropriately, and cost-effectively.
Apply Today
Advance your career in managed care - apply now for our Remote Drug Utilization Review Pharmacist opening.

Apply