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

Sedgwick

RN Field Case Manager

Raleigh, NC · On-site +1

$75K - $96K/yr

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance RN Field Case Manager ...

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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 Sep 2, 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 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.

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.

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.

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.

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.
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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 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $49,422 per year, or $23.8 per hour.

RN Field Case Manager

Sedgwick

Raleigh, NC • On-site, Remote

$75K - $96K/yr

Full-time

Medical, Dental, Retirement, PTO

Re-posted 9 hours ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 327 frontline employees who took The Breakroom Quiz

215th of 315 rated insurance

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

RN Field Case Manager

This Field Case Manger will cover our Raleigh, NC region and must live in this area in order to be considered.

PRIMARY PURPOSE OF THE ROLE: Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties. While frequent travel is required, you will maintain a home-based office.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

  • Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
  • Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment that allows face to face interaction with injured workers and medical professionals.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
  • Enable our Caring counts mission supporting injured employees from some of the world's best brands and organizations.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
  • Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

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ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process.
  • Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation.
  • Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source

EDUCATION AND LICENSING

RN licensure required. Valid driver's license required. High speed internet required. Employment may be contingent upon successful completion of a motor vehicle record (MVR) check.

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

TAKING CARE OF YOU BY

  • Offering a blended work environment.
  • Supporting meaningful work that promotes critical thinking and problem solving.
  • Providing on-going learning and professional growth opportunities.
  • Promoting a strong team environment and a culture of support.
  • Recognizing your successes and celebrating your achievements.
  • We offer a diverse and comprehensive benefits package including:
    • Three Medical, and two dental plans to choose from.
    • Tuition reimbursement eligible.
    • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
    • 4 weeks PTO your first full year.

NEXT STEPS

If your application is selected to advance to the next round, a recruiter will be in touch.

#nurse #fieldcasemanager

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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