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Insurance Nurse Case Manager Jobs in Springfield, MA

Mercy Medical Center

RN - Case Manager

Springfield, MA · On-site

$2.0K/wk

Details Client Name Mercy Medical Center - Springfield Campus Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 37560159 Job Title RN - Case Manager Weekly Pay $2088.0 ...

Mass General Brigham

RN Case Manager

Northampton, MA · On-site

$43.38 - $74.94/hr

Registered Nurse [RN - Massachusetts] required * Case Management certification or active pursuit of certification preferred Experience * Related clinical, continuing care, or case management ...

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Insurance Nurse Case Manager information

See Springfield, MA salary details

$19

$47

$79

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 Springfield, MA is $47.37, according to ZipRecruiter salary data. Most workers in this role earn between $35.19 and $57.26 per hour, depending on experience, location, and employer.

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 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 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 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.

What are popular job titles related to Insurance Nurse Case Manager jobs in Springfield, MA?

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

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

The top searched job categories for Insurance Nurse Case Manager jobs in Springfield, MA are:

What cities near Springfield, MA are hiring for Insurance Nurse Case Manager jobs?

Cities near Springfield, MA 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 Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 81% Physical, 1% Hybrid, and 18% Remote job distribution, with an average salary of $98,523 per year, or $47.4 per hour.

AGENCY - RN CASE MANAGER HOME HEALTH

Berkshire Healthcare

Holyoke, MA • On-site

Other

Medical, Retirement

Re-posted 4 days ago

Job description

RN Case Manager

Benefits: Weekly Pay, 403B retirement plan, Career advancement opportunities

The RN Case Manager will:

  • Assesses patient/family learning needs, style and limitations and adjusts for delivery of information
  • Establishes realistic goals and develops individualized plans of care in collaboration with the patient, family and members of the health care team
  • Collaborates with patient/family and other healthcare providers and/or community resources with planning of care and discharge.
  • Follows physician orders on all patients assigned in accordance with patient care policies
  • Reconciles medications with patient and physician consistently
  • Effectively manages assigned case load, within the team model of care delivery
  • Establishes a daily work plan based upon patient/family priorities of service and total area needs.
  • Promptly triages patient visits, messages, and phone calls according to priority and urgency.
  • Demonstrates excellent physical assessment and care planning skills.
  • Supervises HHA in accordance with state and federal requirements.
  • Demonstrates knowledge of pharmacology and medication administration and reconciliation
  • Communicates and collaborates with all disciplines in the home care setting on a regular basis or immediately if there are any critical needs or crisis interventions.
  • Completes documentation accurately and timely
  • Performs on-call responsibilities and on call services to patients and families assigned
  • Participates in agency quality management and safety activities
  • Participates in ongoing staff meetings and in-services

Qualifications (Minimum qualifications will be considered required unless specifically stated otherwise) Experience: Minimum of one (1) to two (2) years of experience in health care. Minimum of 1 year experience in home health setting. Education and Training: An associate's degree in nursing is required. A bachelor's degree in nursing is preferred. License, Certification & Registration: Possesses and maintains current CPR Certification. Current Massachusetts licensure: Registered Nurse. Valid driver's license and car insurance.

Travel Required Yes. Mileage reimbursement.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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