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Insurance Nurse Case Manager Jobs in Alberta (NOW HIRING)

ROCKY MOUNTAIN CARE GROUP

The RN Case Manager consults as needed with the physician and the office giving details about patient care. Performing accurate OASIS collection, ensuring the medication profile remains current ...

Encompass Health Corporation

Case Manager II

Wildwood, AB

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Case Manager Career Opportunity Recognized for your abilities as a Case Manager Are you ready for a ... For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN ...

Healthy MD

Case Manager

Fort Lauderdale, FL · On-site

The CM will receive guidance from a licensed Nurse Practitioner. The CM shall adhere to ethical and ... Ensures compliance with all State and Federal regulatory guidelines to include Health Insurance ...

Healthy MD

Case Manager - Per Diem

Fort Lauderdale, FL · On-site

The CM will receive guidance from a licensed Nurse Practitioner. The CM shall adhere to ethical and ... Ensures compliance with all State and Federal regulatory guidelines to include Health Insurance ...

Alberta Health Services

Licensed Practical Nurse

Calgary, AB · On-site

CA$33.16 - CA$43.42/hr

In collaboration with the Registered Nurse Case Manager, the LPN is responsible to assess, plan, implement and evaluate the needs of Home Care clients and their caregivers/families. You will play a ...

Alberta Health Services

Licensed Practical Nurse

Calgary, AB · On-site

CA$33.16 - CA$43.42/hr

In collaboration with the Registered Nurse Case Manager, the LPN is responsible to assess, plan, implement and evaluate the needs of Home Care clients and their caregivers/families. You will play a ...

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Insurance Nurse Case Manager information

What is an insurance nurse case manager?

Insurance Nurse Case Managers are registered nurses who work for insurance companies or third-party administrators to help manage and coordinate patient care. They assess patients' medical needs, develop care plans, and act as a liaison between patients, healthcare providers, and insurers. Their primary goal is to ensure that patients receive appropriate, cost-effective care while facilitating communication and helping with claims processes. Insurance Nurse Case Managers also provide education and support to patients and families throughout the treatment process.

How does an insurance nurse case manager typically collaborate with claims adjusters and other healthcare professionals?

Insurance Nurse Case Managers work closely with claims adjusters to review medical documentation, assess treatment plans, and ensure that patients receive appropriate care while managing costs. They frequently communicate with healthcare providers, such as physicians and therapists, to coordinate care and gather information critical to case decisions. This collaborative approach helps streamline claims processing and supports positive patient outcomes, making effective communication and teamwork essential skills for success in this role.

What are the key skills and qualifications needed to thrive as an insurance nurse case manager, and why are they important?

To thrive as an Insurance Nurse Case Manager, you need a registered nursing license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with case management software, health insurance systems, and certifications such as CCM (Certified Case Manager) are typically required. Exceptional communication, organizational skills, and the ability to advocate for patients while balancing payer requirements are key soft skills in this role. These skills ensure effective coordination of patient care, cost management, and positive outcomes for both patients and insurance providers.

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

AspectInsurance Nurse Case ManagerClaims Nurse
CredentialsRN license, case management certification often preferredRN license, claims processing training
Work EnvironmentHealthcare settings, insurance companies, case management teamsInsurance companies, claims departments, healthcare providers
Employer & IndustryInsurance carriers, healthcare organizationsInsurance carriers, third-party claims organizations

The Insurance Nurse Case Manager and Claims Nurse roles both require RN licensure and involve working within insurance and healthcare settings. However, the Insurance Nurse Case Manager focuses on coordinating patient care and managing case progress, while the Claims Nurse primarily reviews and processes insurance claims. Both roles are essential in the insurance industry, but they differ in daily responsibilities and focus areas.

Do insurance nurse case managers make more money?

Insurance nurse case managers typically earn higher salaries than staff nurses due to their specialized role in coordinating care and managing claims. Their compensation can vary based on experience, certifications, and geographic location, with some earning additional benefits such as bonuses or overtime pay. Overall, their advanced responsibilities often lead to higher earning potential compared to general nursing positions.

What are popular job titles related to Insurance Nurse Case Manager jobs in Alberta?

For Insurance Nurse Case Manager jobs in Alberta, the most frequently searched job titles are:

What job categories do people searching Insurance Nurse Case Manager jobs in Alberta look for?

The top searched job categories for Insurance Nurse Case Manager jobs in Alberta are:

Insurance Nurse Case Manager jobs near you
Infographic showing various Insurance Nurse Case Manager job openings in Alberta as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 22% Part Time, and 5% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Case Manager - Terrace Meridian

ROCKY MOUNTAIN CARE GROUP

On-site

Full-time

Posted 22 days ago

Job description

Case Manager

RESPONSIBILITIES

In addition to performing visits and completing coordination of client care, the RN Case Manager is the point of contact for all disciplines involved with providing care to patients and oversees the frequency of visits for the episode. The RN Case Manager consults as needed with the physician and the office giving details about patient care. Performing accurate OASIS collection, ensuring the medication profile remains current, ensuring lab values have been reported to the physician timely, attending weekly case conference and monthly case manager meetings are key responsibilities of this role.

  • Provide all patient care in a manner that reflects respect for patient rights, dignity, and expressed needs
  • Assess the patient’s physical, psychological, and social needs
  • Assess pain and implement appropriate pain management techniques
  • Document patient history, symptoms, assessments, tests, and care according to guidelines
  • Review patient history, diagnostics, and lab data, and report any abnormalities

QUALIFICATIONS

  • Must have a current, unencumbered RN or LPN license in Idaho
  • Certification in CPR
  • Prior clinical experience
  • Excellent communication skills
  • Demonstrated ability to maintain a high level of professionalism during stressful times
  • Strong critical thinking skills
  • Ability to adapt to different clinical settings and environments

Apply