Top 6 Utilization management reviewer Jobs in Raleigh, Nc

Medical Case Reviewer / Administrative Assistant (1099 Contractor)
Shikhara Corp —Raleigh, NC
- $30 - $35 an hour
- No weekends
- Background check
- RN License
- Mid-level
- Paid training
- Flexible schedule
Quick Apply
VP of Preconstruction
Bobbitt Construction, Inc. —Cary, NC
- Full-time
- Civil engineering
- 11+ years
- Bachelor's degree
Medical Director
Senture —Raleigh, NC
- Full-time
- Medicine
- Management
- BC/BE
10d
Staff Associate | Geostructures
BUNNELL LAMMONS ENGINEERING —Raleigh, NC
- Full-time
- Travel
- US work authorization
- 2 years
- Paid holidays
- Disability insurance
Quick Apply
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

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Medical Case Reviewer / Administrative Assistant (1099 Contractor)
Shikhara Corp —Raleigh, NC
We will fully train you on our specific UM software and insurance review processes, but a foundational understanding of medical terminology and clinical…
$30 - $35 an hour
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Office Coordinator
Triangle Springs —Raleigh, NC
Certifications: CPR and De-escalation certification required or obtain within 30 days of hire. Manages organizational tools to ensure efficient operations…
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Clinical Reviewer - Medical Coder & QA
Ohio Living —Westerville, OH
Current unencumbered license for the state of Ohio to practice as a Licenses Practical Nurse (LPN) preferred Certificate for OASIS Specialist-Clinical…
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Board Certified-(M.D, D.O) Ohio Orthopedic Advisor-Certified for IME
Dane Street, LLC —Delaware, OH
Makes telephone calls as mandated by the state and/or client specifics. Identifies, critiques, and utilizes current criteria and resources such as national,…
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Medical Case Reviewer / Administrative Assistant (1099 Contractor)

Shikhara Corp
Raleigh, NC

Quick Apply

Job Details

Contract
$30 - $35 an hour

Benefits

Paid training
Flexible schedule

Qualifications

Dog handling
Associate's degree
Medical terminology

Full Job Description

Job Overview: We are seeking a unique, detail-oriented professional with a mandatory medical background for a full-time position based out of our private home office. This role uniquely combines Utilization Management (UM) case reviews with managing and caring for our six small, friendly Coton de Tulear dogs throughout the work day. While the administrative tasks are identical to a remote role, this position must be performed strictly on-site at our home office so you can seamlessly balance case reviews with dog care. We will fully train you on our specific UM software and insurance review processes, but a foundational understanding of medical terminology and clinical documentation is required.

Employment Type & Schedule:

Type: 1099 Independent Contractor (No benefits provided)
Days: Monday through Friday
Hours: Full-Time (No weekends, no holidays)

Key Responsibilities:

UM Case Reviews: Evaluate clinical documentation and medical cases for medical necessity using insurance guidelines

(training on our specific system provided).

Data Entry & Admin: Maintain accurate digital records, log case details, and track approvals/denials.
Dog Management: Monitor, let out, feed, and manage our six small Cotons in between your administrative tasks.
Office Presence: Maintain a consistent schedule working directly from our dedicated, quiet home office space.

Qualifications & Requirements:

Medical Background (Required): Must be a Medical Assistant (MA), Licensed Practical Nurse (LPN), Registered Nurse (RN), Medical Biller/Coder, or have equivalent clinical/healthcare experience.
Cardiovascular Experience (Highly Preferred): Prior experience in cardiology, vascular medicine, or reviewing cardiovascular charts is a major plus.
Must Absolutely Love Dogs: Enthusiastic, comfortable, and patient enough to manage six small dogs simultaneously.
Reliable & Trustworthy: Absolute integrity and strong professional references are required for this private home office environment.
Background Check: Must be willing to undergo a standard background check.

Compensation & Benefits:

Pay Rate: $30.00 – $35.00 per hour (Negotiable for the right person)
Training: Fully paid, comprehensive training on our specific UM review processes.
Benefits: None (Independent Contractor classification)
Environment: Quiet, comfortable dedicated home office environment with six furry coworkers.

Please include a cover letter (will not consider without a cover letter) indicating that you have read the entire job posting and your salary expectations.

Pay: $30.00 - $35.00 per hour

Benefits:

Flexible schedule

Application Question(s):

Do you have a medical background as a Medical Assistant (MA), Licensed Practical Nurse (LPN), Registered Nurse (RN), Medical Biller/Coder, or equivalent clinical/healthcare experience?
Are you willing to undergo a standard background check?
Are you willing and able to work full-time onsite from our dedicated home office location?
Please read the entire posting , especially the requirement about managing the dogs as well. When you reply please incude a cover letter with the clear understanding that you have read the posting in its entirety

Education:

Associate (Required)

Ability to Commute:

Raleigh, NC 27609 (Required)

Work Location: In person

Quick Apply

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utilization management reviewer jobs in raleigh, nc

Medical Case Reviewer / Administrative Assistant (1099 Contractor)

VP of Preconstruction

Medical Director

Staff Associate | Geostructures

Utilization Management Reviewer

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