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Insurance Nurse Jobs in Virginia (NOW HIRING)

Jackson Nurse Professionals

Travel PICU RN

Richmond, VA · On-site

Full Medical, Dental and Vision Insurance * 401(k) with Employer Match * 24/7/365 Support from your ... Jackson Nurse Professionals Job ID #2603277. Pay package is based on 12 hour shifts and 36 hours ...

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All JobsInsurance Nurse JobsInsurance Nurse Jobs in Virginia

Insurance Nurse information

See Virginia salary details

$23.3K

$58.6K

$96.7K

How much do insurance nurse jobs pay per year?

As of Aug 22, 2026, the average yearly pay for insurance nurse in Virginia is $58,588.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,200.00 and $76,800.00 per year, depending on experience, location, and employer.

What is an insurance nurse?

Insurance nurses, also known as insurance nurse consultants or nurse case managers, are registered nurses who work for insurance companies to assess, review, and manage the medical aspects of insurance claims. They evaluate patient records, coordinate care, and ensure that treatments are medically necessary and cost-effective. Their expertise helps insurance companies make decisions about coverage, benefits, and claims while also supporting patients through care management and education. Insurance nurses often communicate with healthcare providers, patients, and claims adjusters to facilitate the claims process.

What are the key skills and qualifications needed to thrive as an insurance nurse?

To thrive as an Insurance Nurse, you need a solid clinical background (often as a Registered Nurse), strong assessment skills, and knowledge of insurance and medical underwriting processes. Familiarity with electronic health record (EHR) systems, medical coding, and claims management software is commonly required. Excellent communication, analytical thinking, and attention to detail are critical soft skills for evaluating medical information and interacting with clients and insurance professionals. These abilities ensure accurate risk assessment, effective case management, and compliance with regulatory standards in the insurance industry.

How does an insurance nurse typically collaborate with underwriters and claims adjusters?

Insurance Nurses play a crucial role in supporting underwriters and claims adjusters by reviewing medical records, evaluating patient histories, and providing expert insights on health-related risks. They frequently communicate their assessments to underwriters to help determine policy eligibility and premiums, and assist claims adjusters by verifying the validity and extent of medical claims. Effective collaboration requires strong communication skills and the ability to translate complex medical information into clear, actionable recommendations, ensuring that both the clinical and administrative aspects of insurance decisions are well-informed.

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

AspectInsurance NurseCase Manager Nurse
CertificationsRN license, possibly insurance-specific trainingRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare insurance departmentsHospitals, clinics, insurance companies, community health
Primary FocusReviewing insurance claims, verifying coverageCoordinating patient care, managing treatment plans

Insurance Nurses primarily focus on reviewing insurance claims and verifying coverage within insurance companies or departments. In contrast, Case Manager Nurses coordinate patient care and develop treatment plans, often working directly with patients and healthcare providers. While both roles require RN licensure, Insurance Nurses typically have specialized training related to insurance processes, whereas Case Manager Nurses often pursue additional case management certifications. Understanding these differences helps clarify career paths and job expectations in the healthcare and insurance industries.

What are the most commonly searched types of Insurance Nurse jobs in Virginia?

The most popular types of Insurance Nurse jobs in Virginia are:

What are popular job titles related to Insurance Nurse jobs in Virginia?

For Insurance Nurse jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Insurance Nurse jobs in Virginia look for?

The top searched job categories for Insurance Nurse jobs in Virginia are:

What cities in Virginia are hiring for Insurance Nurse jobs?

Cities in Virginia with the most Insurance Nurse job openings:

Insurance Nurse jobs near you
Infographic showing various Insurance Nurse job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 68% Full Time, 27% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $58,588 per year, or $28.2 per hour.

Integrated Nurse Case Manager/Registered Nurse/RN for Chronic/Complex Condition in Fredericksburg, S

Sentara Healthcare

Spotsylvania, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

Sentara Health rating

6.7

Company rating: 6.7 out of 10

Based on 412 frontline employees who took The Breakroom Quiz

530th of 891 rated healthcare providers

Job description

City/State
Fredericksburg, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is hiring an Integrated Nurse Case Manager/Registered Nurse/RN for Chronic/Complex Condition in Fredericksburg, Spotsylvania, VA, and the surrounding areas!
This is a full-time, work-from-home position that requires travel to conduct face-to-face home visits (approx 2-3 times a week) for chronic/complex condition members (asthma, diabetes, heart failure, cancer, heart disease, COPD) Fredericksburg, Spotsylvania, VA, and the surrounding areas!
Status: Full-time, permanent position (40 hours)
Standard working hours: 8am to 5pm EST, M-F
Location: Applicants must reside in Fredericksburg, Spotsylvania, VA and the surrounding areas!
Primary responsibilities include:
  • Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
  • Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
  • Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
  • Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs
  • Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
  • Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
  • May assist in problem solving with provider, claims or service issues.

Target Member Population Includes:
  • High Emergency Room (ER) utilizers
  • Recent hospital discharges
  • Members diagnosed with chronic/complex conditions (Asthma, diabetes, heart failure, cancer, heart disease, COPD)

Education:
  • Associate or Bachelors Degree in Nursing REQUIRED

Certification/Licensure:
  • Registered Nurse (RN) License (Compact or Virginia) REQUIRED

Experience:
  • 3 years experience in Nursing REQUIRED
  • Case Management experience highly preferred
  • Managed Care or Health Plan experience preferred
  • Experience working with chronic/complex condition members (Asthma, diabetes, heart failure, cancer, heart disease, COPD) preferred
  • Experience in home health experience, inpatient case management, hospice, transition of care, and discharge planning preferred
  • Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
  • Excellent communication skills, both oral and written, as well as strong problem-solving and analytical

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.
We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-104113
Talroo - Health Plan
Managed Care, MCO, Health Plan, Healthcare, Health Insurance, Nursing, RN, Registered Nurse, Medicaid, Chronic, Complex condition members, Asthma, diabetes, heart failure, cancer, heart disease, COPD, home health experience, inpatient case management, hospice, emergency room, ED, Emergency Department, Discharge Planning, Case Management, Transition of Care, TOC, Virginia Fredericksburg, Spotsylvania, VA, Remote, Virginia
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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