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Insurance Nurse Case Manager Jobs in Appleton, WI

Rennes Group, Inc.

Insurance Case Manager

WI · On-site

We are inviting you to apply for an Insurance Case Manager position Position is responsible for communicating and verifying resident and patient insurance information in a timely manner to ensure ...

RENNES GROUP

Insurance Case Manager

De Pere, WI · On-site

We are inviting you to apply for an Insurance Case Manager position Position is responsible for communicating and verifying resident and patient insurance information in a timely manner to ensure ...

Compassus

Hospice Registered Nurse- Floating Wisconsin

Neenah, WI · On-site

$76K - $96K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Your position perks as a Hospice Registered Nurse / RN Case Manager * Competitive pay ... Company paid life and long-term disability insurance * Company paid parental leave with tenure for ...

COMPASSUS

Hospice Registered Nurse- Floating Wisconsin

Neenah, WI

$74K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Your position perks as a Hospice Registered Nurse / RN Case Manager * Competitive pay ... Company paid life and long-term disability insurance * Company paid parental leave with tenure for ...

Nuwest Group

RN - Case Management: Appleton, WI

Appleton, WI · On-site

$1.7K - $2.0K/wk

  • Medical

  • Dental

  • Vision

  • Retirement

RN - Case Management We have a new assignment for RN - Case Management in Appleton, WI and are interviewing ASAP. This is a travel assignment, 5x8 Days position at a great facility. Pay Range: $1743 ...

Compassus

Hospice Registered Nurse

Neenah, WI · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Hospice Registered Nurse / RN Case Manager At Compassus, we know that caring for our teammates is ... Company paid life and long-term disability insurance * Company paid parental leave with tenure for ...

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All JobsInsurance Nurse Case JobsInsurance Nurse Case Manager JobsInsurance Nurse Case Manager Jobs in Appleton, WI

Insurance Nurse Case Manager information

See Appleton, WI salary details

$18

$45

$76

How much do insurance nurse case manager jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for insurance nurse case manager in Appleton, WI is $45.59, according to ZipRecruiter salary data. Most workers in this role earn between $33.89 and $55.10 per hour, depending on experience, location, and employer.

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.

What are popular job titles related to Insurance Nurse Case Manager jobs in Appleton, WI?

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

What job categories do people searching Insurance Nurse Case Manager jobs in Appleton, WI look for?

The top searched job categories for Insurance Nurse Case Manager jobs in Appleton, WI are:

What cities near Appleton, WI are hiring for Insurance Nurse Case Manager jobs?

Cities near Appleton, WI with the most Insurance Nurse Case Manager job openings:

Insurance Nurse Case Manager jobs near you
Infographic showing various Insurance Nurse Case Manager job openings in Appleton, WI as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 22% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $94,833 per year, or $45.6 per hour.

RN Case Manager - Madison Area

Sequoia Integrative Medical Services

Kaukauna, WI • On-site

Full-time

Posted 6 days ago

Job description

Job Title: Case Manager Registered Nurse (RN)

Department: Care Coordination
Location: Sequoia Integrative Medical Services
Reports To: Supervisor

Job Summary:

The Case Manager RN is responsible for providing comprehensive care coordination and case management services to patients across the continuum of care. This role involves patient assessment, care planning, resource management, interdisciplinary collaboration, patient advocacy, and follow-up to ensure quality care and positive health outcomes. The ideal candidate will have excellent communication skills, clinical expertise, and a commitment to patient-centered care.

Key Responsibilities:1. Care Coordination:

  • Assess patient needs through comprehensive evaluations, including medical history, psychosocial factors, and functional status.
  • Develop personalized, interdisciplinary care plans in collaboration with patients, families, and healthcare teams.
  • Arrange for necessary services, such as home health, rehabilitation, durable medical equipment, and community resources.
  • Ensure seamless transitions between care settings, such as hospital discharge to home or rehabilitation.

2. Patient Advocacy and Support:

  • Serve as an advocate for patients, addressing barriers to care such as financial concerns, lack of resources, or transportation issues.
  • Provide crisis intervention and connect patients to mental health or social services when needed.

3. Monitoring and Follow-Up:

  • Regularly monitor patient progress, adjusting care plans as necessary to align with changes in the patient's condition or goals.
  • Conduct follow-up calls or visits post-discharge to ensure recovery and adherence to care plans.

4. Interdisciplinary Collaboration:

  • Participate in interdisciplinary team meetings, providing insights into case management and addressing barriers to effective care.
  • Coordinate with physicians, nurses, social workers, and therapists to align care plans and share critical updates.

5. Documentation and Compliance:

  • Maintain accurate and thorough documentation of assessments, care plans, interventions, and outcomes in the Electronic Health Record (EHR).
  • Ensure compliance with regulatory standards and organizational policies, including HIPAA and quality improvement initiatives.

6. Education and Resource Provision:

  • Educate patients and families about treatment plans, medications, and available community resources.
  • Provide disease-specific education and promote self-management strategies for chronic conditions.

7. Continuous Improvement:

  • Use feedback and data to evaluate patient outcomes and improve case management processes.
  • Participate in professional development activities to stay current with best practices in case management.

Qualifications:Education and Certification:

  • Current Registered Nurse (RN) license in Wisconsin..
  • BSN preferred. Case Management Certification is a plus.

Experience:

  • Minimum of 1 year of nursing experience, with a focus on case management, care coordination, or discharge planning.
  • Experience with EHR systems and care management software.
  • Experience in chronic disease management or case management.
  • Strong understanding of chronic conditions and treatment options.
  • Excellent communication skills and ability to work collaboratively with patients and healthcare teams.


Skills and Competencies:

  • Strong clinical assessment and problem-solving skills.
  • Exceptional organizational and time management abilities.
  • Proficiency in patient education and motivational interviewing techniques.
  • Excellent interpersonal and communication skills for effective collaboration with patients, families, and healthcare teams.

Working Conditions:

  • Remote and on location.  Locations vary but are local ALF, up to an hour drive in the Madison area, 25% of position is on site, 75% remote

Key Performance Metrics:

  • Reduction in readmission rates and hospital stays.
  • Improvement in patient satisfaction scores.
  • Successful execution of care plans and positive health outcomes.