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Insurance Case Manager Jobs in Raleigh, NC (NOW HIRING)

Lifepoint Health

Case Manager, Rehabilitation

Apex, NC · On-site

Case Manager Job Type: Full-Time Your experience matters Peak Rehabilitation Hospital is operated ... Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability ...

Valeris

Executive Case Manager (Remote)

Raleigh, NC · Remote

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 ...

NCSU

Assistant Director / Case Manager

Raleigh, NC

... Case Manager Anticipated Hiring Range $65,000 - $75,000 Work Schedule Monday - Friday, 8am - 5pm ... Life Insurance * Accident Plan * Paid Time Off and Other Leave Programs * 12 Holidays Each Year

UNC Medical Center

RN - Case Manager

Chapel Hill, NC · On-site

Case Management Duration: 13 weeks Shift: Days Hours per Shift: 36 Experience: Minimum 2 years of ... Medical, dental & vision insurance * Free and unlimited continuing education units (CEUs) * 24/7 ...

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

Insurance Case Manager information

See Raleigh, NC salary details

$31.6K

$49.4K

$71.9K

How much do insurance case manager jobs pay per year?

As of Aug 8, 2026, the average yearly pay for insurance case manager 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 does an insurance case manager do?

An Insurance Case Manager coordinates and manages insurance claims on behalf of clients, ensuring that cases are processed efficiently and accurately. They review claims, gather necessary documentation, communicate with policyholders, healthcare providers, and insurance companies, and advocate for the best possible outcomes. Their role often involves assessing coverage, resolving issues, and helping clients understand their insurance benefits and options. By serving as a liaison, they streamline the claims process and support clients throughout their case.

What are the key skills and qualifications needed to thrive as an insurance case manager?

To thrive as an Insurance Case Manager, you need a solid understanding of insurance policies, case management practices, and regulatory compliance, often supported by a bachelor’s degree in a related field and relevant certifications such as Certified Case Manager (CCM). Familiarity with claims management software, customer relationship management (CRM) systems, and medical terminology is typically required. Strong communication, organizational, and problem-solving skills help you effectively coordinate between clients, providers, and insurers. These competencies are crucial for ensuring accurate case evaluations, timely claims processing, and high-quality client service.

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

AspectInsurance Case ManagerClaims Adjuster
CredentialsCertifications like CPCU or ARM often preferredAdjuster licenses required by state
Work EnvironmentOffice-based, client interaction, case managementField or office-based, claims investigation
Employer & IndustryInsurance companies, healthcare providersInsurance companies, third-party administrators
Search & Comparison IntentManaging claims, coordinating benefitsEvaluating and settling claims

While both roles work within the insurance industry, Insurance Case Managers focus on coordinating benefits and managing ongoing cases, often requiring certifications like CPCU. Claims Adjusters primarily investigate and settle claims, often working in the field. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

What is an insurance case manager?

An insurance case manager’s duties are to ensure the delivery of health care benefits or other forms of insurance and related services to their clients and to oversee their clients’ cases. As an insurance case manager, you can work in a variety of settings but usually for insurance carriers and HMOs. Your responsibilities differ depending on who your employer is and the type of insurance you work with. For example, if you work for a life insurance company, your duties involve assessing risk, processing new application paperwork, and other tasks similar to that of an underwriter.

Is an insurance case manager a stressful job?

Insurance case managers often handle complex cases involving claims, requiring strong organizational and communication skills. The job can be stressful due to tight deadlines, high workload, and the need to manage multiple stakeholders, but it also offers opportunities for problem-solving and professional growth. Stress levels vary depending on workload, employer support, and individual resilience.

How does an insurance case manager typically collaborate with other departments to ensure smooth claim processing?

Insurance Case Managers frequently work with underwriters, claims adjusters, customer service representatives, and sometimes medical professionals to gather necessary information and resolve complex cases. They act as a central point of communication, ensuring all parties are aligned and that documentation is complete and accurate. This collaboration helps streamline claim evaluations, address any discrepancies swiftly, and deliver timely resolutions for clients. Strong teamwork and clear communication are essential for success in this role.
More about Insurance Case Manager jobs
What job categories do people searching Insurance Case Manager jobs in Raleigh, NC look for? The top searched job categories for Insurance Case Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Insurance Case Manager jobs? Cities near Raleigh, NC with the most Insurance Case Manager job openings:
Insurance Case Manager jobs near you
Infographic showing various Insurance Case Manager job openings in Raleigh, NC as of August 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $49,422 per year, or $23.8 per hour.

Case Manager - Utilization Review

Granville Health System

Oxford, NC • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 21 days ago

Granville Health System rating

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Case Manager - Utilization Review
Location: Granville Health System, Oxford NC
About Granville Health System:
For over a century, Granville Health System has been at the forefront of quality healthcare. To cater to the evolving needs of its community, Granville Health System has extended its services throughout Granville County, ensuring convenient medical care access for its residents. The Granville Health System main campus can be found at 1010 College Street, Oxford, North Carolina. For more details, visit GHS online at www.ghsHospital.org.
About Oxford, NC
Oxford, NC is a charming and welcoming community that offers a perfect blend of small-town charm and modern convenience, making it an ideal place to live and work. Located just about 30 miles north of Durham and 40 miles from Raleigh. The region enjoys a mild, four-season climate with warm summers, crisp autumns, blooming springs, and gentle winters-perfect for enjoying the area's outdoor activities year-round. With a thriving local economy, excellent healthcare facilities, and a strong sense of community, its historic downtown, scenic parks, and proximity to the Research Triangle ensure a balanced lifestyle with both professional and personal fulfillment.
Position Overview:
The primary role of the Case Manager is to review and monitor members' utilization of health care services with the goal of maintaining high quality, cost-effective care. This role will provide the medical and utilization review expertise necessary to evaluate patient status. This includes reviewing clinical information against established criteria, assessing the medical necessity of services and procedures, collaborating with providers and interdisciplinary teams, and ensuring that the patient is placed at the appropriate level of care from the time of admission. This includes providing referral authorization, concurrent review, proactive discharge/transition planning, appropriate referral to case management, and high-dollar claims review.
Position Highlights:
  • Retirement Benefits: NC Local Government Pension Plan (5-year vesting period)
  • Loan Forgiveness: Eligible employer for Public Service Loan Forgiveness (PSLF)
  • Comprehensive Benefits: Medical, dental, vision, life insurance, and various supplemental benefits available

Key Responsibilities:
• Conduct concurrent review of all patients, regardless of payer source, using approved screening criteria
• Perform admission reviews on the first working day following admission
• Conduct continued stay reviews at least every three (3) days or more frequently as indicated
Qualifications
Associate degree in a healthcare-related field or equivalent combination of healthcare experience and education.
At least a year of experience in a related role (utilization review, case management, care coordination, insurance authorization/prior authorization, clinical documentation review, hospital patient access or revenue cycle support, healthcare quality or compliance functions).
Strong attention to detail, organizational skills and interpersonal skills. Ability to interpret clinical documentation and apply review criteria. Strong communication skills for interaction with physicians and interdisciplinary teams. Knowledge of healthcare regulations and payer requirements
Preferred
Bachelor's degree in Health Administration, Public Health, Social Work, Healthcare Management, or related field. Accredited Case Manager (ACM) certification.
Experience with insurance authorization criteria preferred; one year utilization and discharge planning experience.
Apply Today:
If you're a dedicated professional looking for a position with a focus on work-life balance and the opportunity to make a difference, we encourage you to apply for this position with Granville Health System.

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