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Insurance Case Manager Remote Jobs in Raleigh, NC

Valeris

Executive Case Manager (Remote)

Raleigh, NC · Remote

The Executive Case Manager provides expertise on insurance coverage and common access and ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

CVS Health

Case Manager, Registered Nurse

Raleigh, NC · Remote

$54.10K - $155.54K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... self-insured clients. * Application and/or interpretation of applicable criteria and clinical ...

Connecteam

Global Payroll Manager - Remote

Raleigh, NC · Remote

$80K - $100K/yr

Connecteam, based in North Carolina, is looking for a detail-oriented Payroll Manager to oversee ... This fully remote position offers a salary range of $80K-$100K along with medical and insurance ...

Regal Rexnord

Channel Sales Manager (Remote)

Raleigh, NC · Remote

$110K - $135K/yr

We're hiring a Channel Sales Manager to grow strategic markets, drive sales excellence and ... Life and Accidental Death & Dismemberment (AD&D) Insurance * Paid Leaves * Tuition Assistance ...

IQVIA

Lead Clinical Data Manager (Remote)

Durham, NC · Remote

$68.50K - $217.10K/yr

... remote/WFH position with all necessary equipment provided. What You'll Do * Lead data management ... with company match, life insurance, and discretionary PTO * Career growth and learning ...

IQVIA

Lead Clinical Data Manager (Remote)

Raleigh, NC · Remote

$68.50K - $217.10K/yr

... remote/WFH position with all necessary equipment provided. What You'll Do * Lead data management ... with company match, life insurance, and discretionary PTO * Career growth and learning ...

IQVIA

Lead Clinical Data Manager (Remote)

Durham, NC · Remote

$68.50K - $217.10K/yr

... remote/WFH position with all necessary equipment provided. What You'll Do * Lead data management ... with company match, life insurance, and discretionary PTO * Career growth and learning ...

IQVIA, Inc.

Lead Clinical Data Manager (Remote)

Durham, NC · On-site +1

$68.50K - $217.10K/yr

... remote/WFH position with all necessary equipment provided. What You'll Do * Lead data management ... with company match, life insurance, and discretionary PTO * Career growth and learning ...

IQVIA

Lead Clinical Data Manager (Remote)

Raleigh, NC · Remote

$68.50K - $217.10K/yr

... remote/WFH position with all necessary equipment provided. What You'll Do * Lead data management ... with company match, life insurance, and discretionary PTO * Career growth and learning ...

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All JobsInsurance Case Manager Remote JobsInsurance Case Manager Remote Jobs in Raleigh, NC

Insurance Case Manager Remote information

See Raleigh, NC salary details

$31.6K

$49.4K

$71.9K

How much do insurance case manager remote jobs pay per year?

As of May 28, 2026, the average yearly pay for insurance case manager remote in Raleigh, NC is $49,422.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,900.00 and $57,400.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Insurance Case Manager, and why are they important?

To thrive as a Remote Insurance Case Manager, you need a strong background in insurance policies, case management, and claims processing, typically supported by relevant insurance certifications or a degree in a related field. Familiarity with case management software, CRM systems, and electronic document management tools is often required. Exceptional organizational skills, attention to detail, and effective communication are crucial for coordinating with clients and internal teams. These competencies ensure accurate case handling, client satisfaction, and efficient workflow in a remote environment.

How does an Insurance Case Manager collaborate with other departments in a remote work setting?

As a remote Insurance Case Manager, you'll regularly coordinate with underwriters, claims specialists, and external healthcare providers through virtual meetings and secure communication platforms. This collaboration ensures that case files are complete, accurate, and processed efficiently. You may also participate in cross-functional team discussions to resolve complex cases and update workflow standards, all while maintaining compliance with privacy regulations. Strong communication and organization skills are essential for managing these interactions remotely.

What does an Insurance Case Manager do when working remotely?

An Insurance Case Manager working remotely is responsible for assessing insurance claims, coordinating care, and helping clients navigate their insurance benefits, all from a remote location. They communicate with clients, healthcare providers, and insurance companies to ensure claims are processed accurately and efficiently. Remote Insurance Case Managers use secure digital platforms to review case files, document interactions, and provide guidance on coverage and next steps. Their role is vital in ensuring clients receive the care and benefits they are entitled to while maintaining compliance with regulations.

What is the difference between Insurance Case Manager Remote vs Insurance Claims Adjuster?

AspectInsurance Case Manager RemoteInsurance Claims Adjuster
CredentialsLicenses, certifications in case management or health insuranceAdjuster licenses, certifications in claims handling
Work EnvironmentRemote, healthcare or insurance companiesRemote or in-office, insurance companies or third-party administrators
Industry UsageHealthcare, insurance, social servicesProperty, auto, health insurance claims

Both roles often require similar certifications and can be performed remotely. Insurance Case Managers focus on coordinating care and benefits for clients, while Insurance Claims Adjusters evaluate and settle insurance claims. Understanding these differences helps job seekers find the right position aligned with their skills and interests.

What are popular job titles related to Insurance Case Manager Remote jobs in Raleigh, NC? For Insurance Case Manager Remote jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Insurance Case Manager Remote jobs in Raleigh, NC look for? The top searched job categories for Insurance Case Manager Remote jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Insurance Case Manager Remote jobs? Cities near Raleigh, NC with the most Insurance Case Manager Remote job openings:
Insurance Case Manager Remote jobs near you
Infographic showing various Insurance Case Manager Remote job openings in Raleigh, NC as of May 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, and 4% Contract. Highlights an 57% Physical, 7% Hybrid, and 36% Remote job distribution, with an average salary of $49,422 per year, or $23.8 per hour.

Executive Case Manager (Remote)

Valeris

Raleigh, NC • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 24 days ago

Job description

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.
This is a remote role. Candidates must reside in the state of North Carolina.
When you join the team as an Executive Case Manager, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process of getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records, your mastery of the program requirements, and ensuring their prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.
A typical day in this role will include ownership of your patient journey from initiation to closure by using your critical thinking skills and your knowledge of the program and industry rules and standards. This includes completing benefit investigations, tracking prior authorizations / denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk). This role requires a strong understanding of pharmacy and medical billing and coding, excellent communication skills, and the ability to navigate complex reimbursement processes.
The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from PharmaCord and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures.
Key Responsibilities:
  • Relationship Management
    • Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients.
  • Manages all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines.
    • Managed through call/contact center structure, this role supports inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals.
    • Performs post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
    • Manages all client inquiries as appropriate, such as case specific statuses.
    • Manages HCP inquiries, as applicable, pursuant to business rules.
  • All communications with the client’s field teams will remain compliant and adhere to ways of working protocols outlined between PharmaCord and the client teams. Inbound Call Management
    • Manages inbound calls as directed by the program-approved FAQs
    • Triage patients to internal or external resources as appropriate.
  • Personalized Case Management
    • Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine. All communications for case management will follow the guidelines set forth for the program and only provide information publicly available and/or outlined in the patient insert.
    • Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed.
    • Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions.
    • Serves as a subject matter expert to internal team as required and appropriate.
    • Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome.
    • Coordinates nurse teach with nurse educators, as applicable to program.
    • Supports adherence services as applicable to program.
    • Identifies peer support resources for patients.
    • Proactively communicates needs for reverification of prior authorization or re-enrollment.
    • Identifies and reports adverse events, product complaints, special situation reports and/or medical inquiries received in accordance with program operating procedures and the Business Rules.
    • Documents all activities within the PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals.
    • Generate reports and analysis as needed to identify trends and opportunities for improvement.in accordance with business requirements.
  • Utilize Valeris’ values as the driving force behind the team’s success
  • On time adherence to training deadlines for all corporate policies and procedures
  • Ensure all SOPs are followed with consistency
  • Perform additional tasks or projects as assigned
​Qualifications:
  • Completion of Bachelor's degree (or higher) required
    • A degree in healthcare administration, social science or similar related fields is strongly preferred.
  • Minimum two years of experience in healthcare access delivery or management is strongly preferred.
  • 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree.
  • Will consider other certifications and five or more consecutive years of experience in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager).
  • Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
  • Demonstrated examples of executing within guardrails recognizing urgency and consistently delivering patient centric results.
  • Excellent attention to detail and organizational skills.
  • Ability to prioritize tasks and work efficiently in a fast-paced environment.
  • Effective written and verbal communication and interpersonal skills, with the ability to interact professionally with diverse stakeholders.
  • Demonstrates the ability to think critically and issue resolution.
  • Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.
  • Bi-lingual skills are a plus.
  • Remote work eligibility is subject to all work from home criteria met and based on business need
Physical Demands amp; Work Environment
  • While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
  • Although very minimal, flexibility to travel as needed is preferred.
  • This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
  • Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
  • Additional health support, including telehealth and Employee Assistance Program (EAP) services
  • Company match on Health Savings Account contributions
  • Free Basic Life and AD amp;D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
  • Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
  • 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
  • Paid Time Off (PTO) and Sick Leave to support work-life balance
  • Team members receive nine paid holidays plus two floating holidays
  • Opportunities for advancement in a company that supports personal and professional growth
  • A challenging, stimulating work environment that encourages new ideas
  • Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
  • A mission-driven, inclusive culture where your work makes a meaningful impact
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
Important Notice

Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @pharmacord.com and/or @valeris.com, @echo.newtonsoftware.com email address regarding next steps in our interview process.

Please Note:
  • PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @valeris.com, @pharmacord.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly.
  • We will never request your bank account information at any stage of the hiring process.
  • We will never send a check (electronic or physical) to purchase home office equipment.

If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@pharmacord.com

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