Occupational Therapy Assistant Jobs in North Carolina
Occupational Therapy Assistant jobs in North Carolina are in strong and steady demand, concentrated in skilled nursing facilities, pediatric clinics, school systems, and inpatient rehabilitation centers, with openings at every level from new graduate to senior clinician. The heaviest hiring runs through Charlotte, Raleigh-Durham, and Greensboro, where employers such as Atrium Health, WakeMed Health and Hospitals, and Novant Health maintain large and ongoing occupational therapy assistant rosters. Hand therapy, pediatrics, and geriatric rehabilitation are the most consistently sought specializations across the state. Find a role that fits below and apply directly.
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Overview
Hand in Hand Therapy is seeking a compassionate, creative, and dependable Certified Occupational Therapy Assistant to join our pediatric team. The COTA will provide individualized occupational therapy services under the supervision of a licensed occupational therapist and in accordance with each child’s established plan of care.
This position is ideal for someone who enjoys working closely with children and families, values clinical collaboration, and wants the flexibility to build a schedule that supports a healthy work-life balance.
Responsibilities
- Provide individualized, play-based occupational therapy interventions under the supervision of an occupational therapist
- Implement established plans of care and work toward measurable, functional goals
- Select and adapt therapeutic activities according to each child’s abilities, interests, regulation needs, and progress
- Address areas such as fine motor development, visual-motor integration, sensory processing, self-regulation, executive functioning, self-care, feeding, and participation in daily routines
- Complete accurate, professional, and timely treatment documentation
- Communicate treatment progress and relevant recommendations to families
- Collaborate with the supervising occupational therapist regarding progress, concerns, and potential changes to intervention
- Maintain client safety, privacy, confidentiality, and professional boundaries
- Participate in required supervision, team communication, and professional development
- Maintain compliance with clinic policies, payer requirements, and applicable state and federal regulations
Qualifications
- Graduate of an accredited Occupational Therapy Assistant program
- Current NBCOT certification as a Certified Occupational Therapy Assistant
- Current or eligible North Carolina Occupational Therapy Assistant license
- Professional liability insurance
- Current CPR/BLS certification
- Ability to complete required background checks and credentialing
- Strong communication, organization, and time-management skills
- Dependable, professional, and comfortable working both independently and collaboratively
The Ideal Candidate
The right person for this position:
- genuinely enjoys connecting with children and their families
- uses a creative, playful, and child-centered approach
- understands that behavior is communication
- values collaboration and welcomes constructive feedback
- can adapt interventions in response to a child’s needs
- communicates professionally and compassionately with families
- completes documentation accurately and efficiently
- is dependable, proactive, and committed to providing excellent care
Pay: $40.00 per hour
Benefits:
- Flexible schedule
Work Location: In person
See All 119+ Occupational Therapy Assistant Jobs in North Carolina
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Find JobsOccupational Therapy Assistant Jobs by City in North Carolina
Where North Carolina roles are concentrated, by current openings.
Occupational Therapy Assistant Job Market in North Carolina
A snapshot from current North Carolina openings, updated as new roles post.
Who's Hiring
- Broad River Rehab22

- Evolve Therapy Services10

- Advocate Aurora Health6

- Liberty Healthcare Companies6

- TransPerfect Health5

Top Industries Hiring
- Healthcare & Medical Services
- Insurance
What North Carolina Employers Look For
The qualifications that appear most often in occupational therapy assistant jobs across North Carolina.
- Active North Carolina Occupational Therapy Assistant license issued by the NC Board of Occupational Therapy
- Associate degree from a ACOTE-accredited occupational therapy assistant program required
- Current NBCOT COTA certification in good standing
- Experience working in skilled nursing, inpatient rehabilitation, or pediatric clinical settings
- Proficiency with electronic health records such as Epic or Meditech
- Valid CPR and Basic Life Support certification maintained throughout employment
Occupational Therapy Assistant Jobs in North Carolina: Frequently Asked Questions
How do you become a occupational therapy assistant in North Carolina?
To become an occupational therapy assistant in North Carolina, you must complete an associate degree from an ACOTE-accredited program, pass the NBCOT COTA national certification exam, and then apply for licensure through the North Carolina Board of Occupational Therapy. The board requires proof of your NBCOT certification and a completed application before you can practice legally in the state. Several community colleges across North Carolina, including Cape Fear Community College and Cabarrus College of Health Sciences, offer accredited programs.
How much do occupational therapy assistants make in North Carolina?
Occupational therapy assistants in North Carolina earn a median of about $69,390 a year, based on May 2025 Bureau of Labor Statistics wage data, ranging from around $55,130 for the lowest 10% to over $83,360 for the top 10%. Pay rises with experience, specialty, and employer.
Which companies hire occupational therapy assistants in North Carolina?
Employers hiring occupational therapy assistants in North Carolina right now include Broad River Rehab, Evolve Therapy Services, and Advocate Aurora Health, based on current listings on Migrate Mate as of October 2026. North Carolina's large integrated health systems and growing network of skilled nursing and rehabilitation facilities keep demand consistent across both urban centers and rural communities throughout the state.
Which North Carolina cities have the most occupational therapy assistant jobs?
The cities with the most occupational therapy assistant openings in North Carolina are Raleigh, Fayetteville, and Asheville. Charlotte and Raleigh-Durham lead because of their concentration of major health systems, academic medical centers, and pediatric specialty clinics, while Greensboro draws volume from its established network of skilled nursing and long-term care facilities serving the Triad region.
Are there remote occupational therapy assistant jobs in North Carolina?
Yes, but they're rare. Occupational therapy assistant work is inherently hands-on, requiring direct patient contact for assessment and treatment, so most roles are fully on-site. About 6% of occupational therapy assistant openings tied to North Carolina are remote or hybrid as of October 2026, and those positions are typically limited to documentation support, care coordination, or telehealth roles at larger health systems rather than direct clinical treatment.
How can I get hired as a occupational therapy assistant in North Carolina with little or no experience?
The most realistic entry path is applying for occupational therapy assistant roles at skilled nursing facilities, which in North Carolina tend to be the most open to new graduates alongside hospitals. Atrium Health and Novant Health both run structured new-graduate onboarding programs that pair COTAs with supervising occupational therapists during the early months. Rehabilitation aide and restorative aide positions at North Carolina long-term care facilities are strong lateral entry points that build clinical exposure before stepping into a licensed COTA role. Completing your fieldwork rotations at a North Carolina employer you want to join gives you a recognized credential and an internal advantage.
Where can I find and apply to occupational therapy assistant jobs in North Carolina?
You can find and apply to occupational therapy assistant jobs in North Carolina on Migrate Mate, which lists current openings from employers actively hiring in the state. Search the listings, find roles that match your experience and preferred location, and apply directly to the ones that fit.
See All 119+ Occupational Therapy Assistant Jobs in North Carolina
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