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Insurance Case Manager Jobs in Reston, VA (NOW HIRING)

LAUKOA

Registered Nurse Case Manager

Fairfax, VA · On-site

Manage Soldier's case from the identification of the condition to when the Soldier is either ... LAUKOA offers a best-in-class benefits program including medical, dental, and vision insurance; a ...

GQR Global Markets

RN Case Manager

Woodbridge, VA · On-site

$3.3K - $3.4K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Woodbridge ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

GQR

RN - Case Manager

Woodbridge, VA · On-site

$3.3K - $3.4K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Woodbridge ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

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Insurance Case Manager information

See Reston, VA salary details

$33.8K

$52.9K

$77K

How much do insurance case manager jobs pay per year?

As of Sep 1, 2026, the average yearly pay for insurance case manager in Reston, VA is $52,893.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,600.00 and $61,400.00 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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What cities near Reston, VA are hiring for Insurance Case Manager jobs?

Cities near Reston, VA with the most Insurance Case Manager job openings:

Insurance Case Manager jobs near you
Infographic showing various Insurance Case Manager job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 70% Full Time, 23% Part Time, 1% Temporary, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $52,893 per year, or $25.4 per hour.

Registered Nurse Case Manager

LAUKOA

Fairfax, VA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Job description

Mahalo for your interest in this role! Please see the full position description below and click Start Your Application when ready.

SUMMARY:

LAUKOA is currently seeking applicants to fill our Registered Nurse Case Management position for administrative services supporting the Louisiana Army National Guard (LAARNG) State Surgeon's Office.

DUTIES AND RESPONSIBILITIES:

  • Contractor shall track and manage medical status of all assigned Soldiers through military systems of record.
  • Schedule profile exams/evaluations at medical readiness events.
  • Contractor shall check, and action all referrals from MEDCHART DOD systems daily. Contractor shall action these referrals by scheduling a follow up appointment with an Army medical provider, requesting further medical documentation, and following recommendations from provider as detailed in the referral for further actions.
  • Correspond with medical readiness officers and/or Soldiers to obtain information for the Soldier's case management file, as requested by a provider or detailed in Army regulations.
  • Manage Soldier's case from the identification of the condition to when the Soldier is either considered medically ready and returned to duty or administratively separated from the military.
  • Educate Soldiers on resources available to improve medical and dental readiness.
  • Review, track, and update health assessment lab results and contact SM and educate on lifestyle modifications.
  • Update MODS and other military systems of record as required on the following: immunizations, designation of pregnancy, eye exams, and medical warning tags.
  • Track interaction with SM about medical appointments by communication with unit to ensure Soldier attendance and submission of follow up documentation.
  • Contractor shall run MEDPROS reports prior to MRE to compare received rosters and medical needs of SM pre-event. Contractor shall run MEDPROS reports post event to ensure all scheduled services are completed/updated and current medical status is reflected.
  • Ensure Soldiers with permanent three or four PULHES are brought to the attention of the State Surgeon Office to ensure IDES referrals shall be tracked. (A profile containing one or more numerical designators of "3" signifies that the individual has one or more medical conditions or physical defects that may require significant limitations and referral to the integrated disability evaluation system (IDES) system. These cases are to be tracked and monitored by case managers.
  • Contractors shall stay current on all guidelines and regulations impacting Case Management and Medical Records
  • Contractors shall prepare medical documentation for Line of Duty (LOD) investigation for units for which they are responsible in conjunction with Health Service Support (HSS).
  • Contractor shall prepare individual vouchers for SM IMR requirements into the Automated Voucher System (AVS) when Soldiers treatment cannot be completed at MRE.

QUALIFICATIONS:

  • Active, unrestricted registered nurse (RN) license without restrictions
  • CPR/BLS Certification
  • A valid US driver's license
  • Knowledge of common assessment tools used by medical/dental professionals to complete evaluations
  • Excellent customer service skills and experience interacting with difficult clientele face to face, via email, and on the telephone
  • Shall have the ability to work independently without supervision and also as part of a team
  • Personal Computer (PC) proficiency, specifically Microsoft Teams, Outlook, SharePoint, Word, and Excel
  • Ability to work in a fast-paced environment and adapt to changes quickly
  • Ability to work for lengthy periods and perform accurately with adequate speed
  • Must submit no less than two professional references with a resume

PREFERRED QUALIFICATIONS:

  • Working knowledge of the regulations and policies that apply to Individual Medical Readiness (IMR) and deployment
  • Experience working in a Military setting
  • Previous Common Access Card (CAC) holder

*This Position is Contingent Upon Award.

LAUKOA is an Equal Opportunity/VEVRAA federal contractor. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law.

LAUKOA offers a best-in-class benefits program including medical, dental, and vision insurance; a 401(k) program with employer match; paid vacation and sick leave; employer-paid basic life and AD&D insurance; an Employee Assistance Program; and a flexible work environment. Additionally, employees can choose from several voluntary benefits including critical illness coverage; accident insurance; identity theft coverage; pet insurance, and more.

LAUKOA gives preference to internal candidates. If no internal candidate meets our qualifications, external candidates will be given consideration.

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