10 Best Nurse Practitioner Jobs With Insurance Companies – 2023
Written By: Donna Reese MSN, RN, CSN
Insurance companies have utilized nurse practitioners for case management for many years to help save costs and ensure quality care for their clients. More recently, the role of an insurance company NP has expanded beyond traditional roles. If you are considering making the switch to a new career and are curious about this line of work, you may ask what are the best nurse practitioner insurance jobs? Read on for some personal insights about my experience working in case management and utilization review along with the 10 best nurse practitioner jobs with insurance companies in 2023. Hopefully, you gain a better understanding of some new NP roles and perhaps find one that will captivate your interest for your next career move!
Why Do Insurance Companies Need Nurse Practitioners?
Nurse practitioner jobs with insurance companies are a win-win combination. Insurance companies employ nurse practitioners to assist in keeping health costs down for both the patient and the insurers. Insurance companies can save millions of dollars in unnecessary healthcare costs by hiring NPs to ensure that unnecessary tests, procedures, and surgeries are screened prior to authorization. In turn, nurse practitioner insurance jobs can be a pretty gratifying career for an NP. Let’s explore why both insurance companies and nurse practitioners can benefit from this union.
RECOMMENDED ONLINE NURSE PRACTITIONER PROGRAMS
5 Advantages Of Nurse Practitioner Insurance Jobs
There are many pros to working as a nurse practitioner for insurance companies.
I will list a few as follows:
Having worked for a medical management and utilization review organization as a nurse, I can attest that the environment is very different from a typical nursing position. I especially enjoyed working with a diverse variety of professionals. From insurance adjusters to physicians and lawyers, my colleagues no longer resembled that of hospital staff. In addition, it was a pleasant change to get out of scrubs and buy professional work clothing. My days consisted of some travel outside of the office. I appreciated real lunches in restaurants, which contrasts the sometimes stifling hospital atmosphere where lunch was a laughable 5 minutes. Each day was a little different and I enjoyed the variety of the position.
2. Work Remotely-
Many insurance jobs for nurse practitioners can be accomplished remotely. Some advertise the position as a 100% remote job, while others may require that the NP do paperwork from home but require home visits to clients for assessment.
3. No Direct Patient Care-
Although NP jobs with insurance companies often require that a nurse practitioner works with clients, no direct patient care is necessary for many positions. NPs may perform home assessments or telephone guidance of care but the NP is not the primary caregiver in these instances.
4. Utilization of Medical Knowledge-
Nurse practitioners employed by insurance companies can be satisfied that they incorporate all of their medical knowledge. Advanced judgment is necessary to fully support and guide their clients while still assisting the insurance companies in utilizing their healthcare funding wisely.
5. Work Independently-
Although you will have a boss or 2, insurance work for a nurse practitioner is pretty autonomous. You may be the lone medical professional. Therefore, you will receive much latitude in the position along with respect for your credentials and knowledge that you bring to the table. In my past career as a medical management nurse, I always felt very respected and given free rein on the job.
5 Drawbacks Of Nurse Practitioner Insurance Jobs
Having worked many pleasant years with an insurance company, I feel that there are a few cons to working as an NP for an insurance company.
Here are a few drawbacks of nurse practitioner insurance jobs that you should be aware of:
It may be necessary to travel during the day to visit clients, physicians, or attorneys. Although some nurse practitioners enjoy getting out of the office, others may view travel as a drawback.
2. No Direct Patient Care-
Once again, what one NP feels is a good thing, another may not. Some NPs may miss direct patient care in the long run.
3. Fear Losing NP Skills-
Most likely, you will not be suturing and looking into ears while employed with some insurance companies. Therefore, indeed, your NP hands-on skills may get a little rusty.
4. Miss Medical Colleagues-
Although you will be with a whole new set of work colleagues, you may miss the regular contact with other nurses, doctors, and medical professionals.
5. Remote Work Has Its Own Drawbacks-
There are some disadvantages to working remotely as a nurse practitioner
. For extraverts, remote work can be lonely. In addition, NPs who have difficulty organizing their work and working independently may not be successful working from home.
WHAT ARE THE BEST NURSE PRACTITIONER JOBS WITH INSURANCE COMPANIES?
(Learn about the 10 Best Nurse Practitioner Jobs in Insurance Companies for 2023.)
1. Utilization Review
Sometimes called a nurse auditor, nurse practitioners review medical bills to determine if the costs are reasonable and related to the diagnosis. Having audited many hospital and physician bills in the past, I found this position to consist mainly of paperwork. I utilized my experience and medical knowledge to analyze patient records and accounts to find errors and reasonable costs. Excellent communication skills are necessary as fees and overcharges may need to be negotiated to reach a final determination.
An NP who works as a utilization reviewer (UR) may be employed by HMO’s, insurance companies, hospitals, or independent utilization review organizations. There are many benefits of this position. Working remotely is possible for many UR positions. In addition, job stress is low and autonomy is encouraged. As a utilization reviewer, I enjoyed meeting new people and found working in an office atmosphere to be a breath of fresh air compared to the hospital environment.
2. Home Assessment
A quick look on job boards reveals that nurse practitioner jobs with insurance companies are abundant for those willing to do home assessments. Full and part-time work in this specialty area is offered. NPs are contracted and paid per home assessment, so this position could even serve as a side job for those employed elsewhere. NPs who provide home assessments may be utilized by insurance companies and HMOs.
Nurse practitioners who do home assessments review medical records and go into patient homes or extended care facilities to assess the patient's condition. In turn, the NP will then act as a liaison with the insurance company and patient to develop an appropriate and cost-effective medical treatment plan. This position may be a hybrid position of remote work from home along with some travel to the patient’s residence.
This low-stress job has plenty of autonomy. One nice feature of providing home assessments is that an NP will utilize assessment skills and have the opportunity to educate patients.
3. On-site Minute Clinic
Perhaps you may not be aware that CVS pharmacy has merged with Aetna insurance
. Keeping up with the trend for large health corporation mergers, CVS Health is now one of the nation's premier health companies. Therefore, NPs employed by Aetna are also CVS employees.
One of the primary employers for nurse practitioners is CVS Minute Clinics. Nurse practitioners who desire to work in a small clinic atmosphere with a more focused clientele may enjoy working at a minute clinic. An NP rarely needs to deal with emergencies as the job primarily consists of providing family health assessments and treatment for everyday illnesses and conditions. Administering injections, STD testing, pregnancy prevention counseling and patient education make this position interesting for those who enjoy family health.
Encounters are by appointment only creating a lower stress environment than many urgent care NP jobs. Hours may involve evenings and weekends but no call is necessary.
4. Case Management
Case management is one of the more familiar nurse practitioner jobs with insurance companies. Insurance companies are many times under the umbrella of larger HMOs and health corporations. Therefore, NPs who work as case managers are typically employed by a larger corporation than a free-standing insurance agency.
Advanced practice nurse case managers
utilize their impressive medical knowledge and exceptional patient education skills to manage clients with complex and/or chronic health conditions. Cases can be across life’s spectrum, from managing pregnant women to the elderly. By assessing and directing care, NP case managers help patients to achieve positive health outcomes.
I worked as a case manager in my early nursing years dealing with catastrophic workmen’s compensation cases. I found the job satisfying as a mother partially due to working regular 9-5 office hours. I formed gratifying relationships with clients with amputations, spinal cord injuries and traumatic brain injuries as I managed their care anywhere from 3 months to several years. At a very low point in my clients' lives, I felt like I could assist them in rebuilding their lives.
5. Remote NP for Medicare
Medicare contracts insurance companies and HMOs to monitor clients who receive Medicare benefits. These companies employ nurse practitioners to manage healthcare to contain medical costs by reducing hospital readmissions and unnecessary procedures. Medicare-related nurse practitioner jobs in insurance companies are a big business as Medicare costs can sky-rocket without the checks and balances provided by astute and caring NPs.
Since the Covid pandemic, many insurance positions have become remote in nature.
NPs who work with Medicare clients review their medical records and guide and oversee healthcare via a phone call from the convenience of home. With the ability to provide virtual visits, NPs can also provide assessments and check-ups online, if necessary. Nurse practitioners in this position will need to become familiar with Medicare regulations.
In addition, NPs working for Medicare may review bills and negotiate payments to keep the charges fair and reasonable. This low-stress job has regular 9-5 work hours and no direct hands-on patient care.
6. Director of Case Management
A director of case management oversees a team of nurses in the case management department of an insurance company or HMO. NPs are well suited for this position as the director needs to possess superior medical knowledge and experience in the medical field. In addition to being the final say in more complex medical cases, the NP manager needs to provide training and supervision for the staff.
Extensive nursing experience and a varied nursing background are essential in this role as cases may involve infants, children, adults, and pregnant women. Therefore, family nurse practitioners
are in demand for this position.
Working regular office hours and limited patient care is a plus of this position. Nurse practitioners seeking a management career
may find this position ideal, especially if hospital nursing is not appealing. As a manager, there may be some stressful moments but they may seem minimal compared to inpatient administration jobs.
7. Director of Quality Improvement
As one of the essential administrative nurse practitioner insurance jobs, a director of quality improvement (DQI) provides strategic leadership for the insurance team. A DQI can work for private insurance, large HMO’s or Medicare/Medicaid. This position is responsible for establishing quality of care for patients along with cost-effective access to care. A DQI ensures that state Medicaid standards
are met and are in compliance for those working with patients under the Medicaid umbrella.
An NP who is a director of quality improvement needs to possess exceptional communication and leadership skills
. Primarily a desk job, a DQI spends much time establishing programs, working on policies and protocol, in meetings, and ensuring that best practices are established.
In addition to at least 5 years of clinical experience, a background in quality management, quality improvement, or healthcare operations experience is necessary for this unusual NP position.
8. Occupational Health
Some large insurance companies and HMOs employ NPs as occupational health practitioners
. Occupational health NPs ensure that safety precautions are in place onsite and provide health promotion programs for the workforce. In addition, NPs have been employed to provide Covid testing, vaccines, and guidance during the pandemic this past year.
Adult health nurse practitioners
and FNPs are well suited for a career in occupational health due to their expertise with the working population. This ideal position allows an NP to utilize some skills such as physical assessment, ordering and performing tests, and patient counseling. Working office hours is a welcomed perk, along with a typically pleasant clientele and work environment.
9. Health Coach
As one of the newer nurse practitioner jobs with insurance companies, health coaches are at the frontline in controlling insurance costs. Insurance companies achieve cost-containment by offering health coaches who are available 24/7 to assist with medical issues for insured clients. By making medical advice easily acceptable by phone, insurance corporations can cut down on their insured client's uncontrolled medical conditions and unnecessary ER visits.
The position of a health coach can be similar to that of telemedicine
as both offer guidance and medical advice to patients over the phone. However, NP health coaches do not prescribe medicine and do not act as the primary caregiver for patients. Instead, health coaches guide clients towards a healthier lifestyle by helping them seek appropriate medical care and offering health advice and teaching. A health coach is available for questions and support and generally assists patients in achieving their health goals.
Nurse practitioners are essential in assisting clients through complex and serious medical conditions such as cancer and diabetes.
Health coaches can assist clients in many other ways, such as:
◦ Scheduling medical appointments
◦ Arranging for in-home care
◦ Facilitate communication with specialists and primary doctors
◦ Provide resources for social workers, durable medical equipment, and other necessary medical needs
10. Psychiatric Nurse Practitioner
An exciting position for a psychiatric nurse practitioner
is one with insurance corporations. In this role, a psychiatric mental health nurse practitioner (PMHNP) is consulted to work with primary care providers to provide insight and guidance on insured clients' mental health and behavior issues. NPs in this role do not have a lot of patient interaction but are hired for their mental health expertise to guide physicians with their patients. Much of the time, an NP can accomplish this job remotely.
Clients may be in long-term care facilities, at home, in a hospital, or hospice.
As a nurse consultant, you will work regular 9-5 office hours, no weekends or on-call. For nurse practitioner insurance jobs, a PMHNP should find this job to be a very low-stress position with excellent pay. PMHNPs are among the highest-paid nurse practitioners
due to the very high demand for NPs in this specialty. In this low-stress, high-paying position, a PMHNP is sure to find a satisfying career.
WHAT ARE THE BEST INSURANCE COMPANIES FOR NURSE PRACTITIONERS TO WORK FOR?
(Learn about the 10 Best Insurance Companies to work for as a Nurse Practitioner in 2023.)
1. United Health Group
As I researched this article on nurse practitioner jobs with insurance companies, United Health Group popped up repeatedly. I found this organization to have merged 2 complementary businesses to form a sizeable successful healthcare system. United Health Group now encompasses both those who pay for and those who provide healthcare by uniting with OptumHealth.
United Healthcare offers health plans for every age along with Medicare coverage. The other side of this leader in the health industry is OptumHealth. Optum provides clinical care through 3 different branches called OptumHealth, OptumInsight, and OptumRX.
OptumHealth provides care services directly to hospitals, clinics, private medical offices, and long-term care facilities. OptumHealth employs a legion of nurse practitioners in a variety of environments and positions. Main areas of employment
are at clinical sites or in health care operations.
2. Valor Health Plan
Valor Health Plans are designed explicitly for Medicare patients who reside in long-term care facilities. Valor is an HMO with Medicare contracts across the US. Valor employs local “hands-on” nurse practitioners to act as case managers to coordinate quality care for their clients.
As case managers for Valor Health Plans, NPs work mainly remotely but may have the opportunity to meet with their clients if the need arises. By investigating and coordinating complex and chronic medical conditions, the case manager can establish meaningful relationships with their senior clients while controlling costs for the insurer.
3. CVS Health (Aetna)
As related previously, Aetna insurance is now a part of CVS Health. This complementary alliance has opened up a wide variety of nurse practitioner insurance jobs. One such job is that of a utilization management nurse consultant. In this position, an NP gathers client health information, analyses it and then helps to coordinate care to provide quality treatment at a reasonable cost to Aetna.
With numerous nurse practitioner positions all over the US, CVS Health
is a great place to start your job search if you are interested in pursuing nurse practitioner jobs with insurance companies.
Another leader in the health insurance industry is Humana. Providing Medicare coverage to over 26 million people
across the US, Humana offers health, dental, vision and fitness plans to fit everyone’s lifestyle. With so many clients to take care of, there is a demand for medical case managers with Humana.
Humana offers a variety of NP positions
, with many centered in the warmer states like Florida, Arizona, and Texas. As “snowbirds” move to more temperate climates, so does the demand for NP with a background in adult-gerontology
Nurse practitioner jobs in insurance companies can be diverse. Humana is one such company. This innovative corporation participates in numerous outreach programs such as Humana/Senior Bridge's Tuberculosis (TB) screening program. This program is just one of many areas that hire NPs. For this particular incentive, NPs are an integral part of assessing, diagnosing and treating senior patients with TB. In addition to placing nurses onsite for specific programs, Humana employs NPs as care coaches and case managers.
5. Sharecare and CarePlus Health Plans
In what appears to be the wave of the future, Sharecare and CarePlus Health Plans have partnered together
to improve healthcare for their policyholders. CarePlus Health Plans provides quality and affordable Medicare coverage to the millions of senior recipients in Florida. Sharecare is an innovative healthcare corporation that manages care for patients along with scientific digital health platforms
for providers and the healthcare industry in general.
Sharecare employs nurse practitioners
as care managers to ensure that their clients receive high-quality personalized care. Care managers may work remotely or onsite as the arises. In this position, NPs must interface with physicians to better understand their clients' treatment plan and guide and intervene to maximize their health.
6. Blue Cross Blue Shield
As one of the oldest and most trusted insurance companies, Blue Cross Blue Shield (BCBS) offers a variety of affordable medical insurance plans, including Medicare and Obamacare policies. The BCBS corporation is broken down into 35 independent local companies across the US to provide local, personalized service to those they insure.
As with many other large insurance corporations, Blue Cross Blue Shield
has branched out into the healthcare industry to synthesize insurance plans with accessible and quality healthcare to better serve their consumers. They have labeled this union as a blended approach
. In addition to the traditional nurse practitioner insurance jobs such as case management and utilization review, Highmark Health, an affiliate of BCBS, places nurse practitioners in a wide variety of inpatient and outpatient facilities.
7. Anthem, Inc
Anthem Inc is the largest for-profit insurance and managed care corporation. They pride themselves on their commitment to healthcare for all. As one of the Fortune 500 company's
best places to work in 2021, Anthem Inc seems to be one of the better options for those looking out for nurse practitioner jobs in insurance companies.
Anthem branches off into numerous smaller care systems where patients are supported by a team of clinicians responsible for coordinating care and assisting patients in navigating the medical system for care successfully. This translates to non-rushed provider visits via telemedicine, in-home or at care facilities and an ongoing patient-provider relationship.
Anthem offers a variety of nurse practitioner jobs
. NPs working for one of Anthems health companies can be found working at a “care center”, a patient’s home, or from home working remotely. Mainly daylight hours, NPs at some locations may be required to work weekends and holidays.
As a more obscure insurance corporation, Centene is listed in the top 5 revenue makers in the industry. Recent success in the “marketplace” and the acquisition of Wellcare
has helped bolster the progress of this company. Centene, along with Wellcare, provide Medicare and Medicaid plans and private health plans for various age groups.
nurses and nurse practitioners for various roles, with some being remote and others on-site. Some nurse practitioner jobs with Centene are:
◦ Pharmacy Specialist
◦ Utilization Review
◦ Case Management
◦ Appeals Nurse
◦ Quality Compliance Nurse
With Medicaid enrollees accounting for a large majority of its total enrollment, Molina is a rising star among health insurers. Sometimes behind the scenes, Molina has contracted with some impressive and quality health service programs such as the State Children Health Insurance Plan (CHIP) and Medicare and Medicaid programs. They also offer marketplace plans. In the health industry for over 35 years, Molina is a safe bet for nurse practitioner jobs in insurance companies.
Molina Health prefers that NPs have a family health background along with home health experience. An NP working for Molina Health may be working in homes, long-term care facilities, or public “pop-up” clinics. Patient appointments are a hybrid of in-person and virtual visits.
are part of a team with responsibilities that include:
◦ Physical Assessment
◦ Ordering of tests, procedures, and medication
◦ Developing treatment plans
◦ Administering vaccines
10. Kaiser Permanente
Kaiser Permanente has the combined health coverage and medical care that their clients require all figured out. Those insured through Kaiser Permanente are assigned a case manager and primary care provider to tailor individual care right from the get-go. Those with certain chronic and life-altering conditions such as cancer and diabetes will also get a health coach to help navigate the complex healthcare system.
Kaiser Permanente Nurse Practitioners
work in a variety of settings and specialty areas such as:
◦ Employee Health
◦ Nursing Home Services
◦ Occupational Medicine
The job list goes on and on. Kaiser Permanente is a massive health system that employs over 86,000 providers and nurses.
5 Ways To Know Which Nurse Practitioner Insurance Job Is Right For You
As individuals, we all have specific and unique wants and needs when it comes to a job. As with any job, we have to weigh our preferences, background, lifestyle, and home commitments. All of these qualities need to be factored into whether a job is the right fit
Factors to consider when choosing nurse practitioner insurance jobs are:
1. Will the position be a good fit for my nursing background?
2. Will I be satisfied working this job with my family, home life, and lifestyle?
3. Will this job challenge me as a nurse practitioner?
4. Can I picture myself in this work environment?
5. Make sure that you do your homework. Thoroughly research the job, organization and your boss before leaping into your perfect NP position at an insurance company. Ask questions and make sure that you feel comfortable with your decision. If you get a good feel for the job and it speaks to you, your choice will become clear.
How Much Can You Make In Nurse Practitioner Jobs With Insurance Companies?
The average nurse practitioner working in case management
makes $95,284 yearly. However, NPs employed by some larger organizations such as United Health Group make $114,722 plus a $2500 sign-on bonus, according to Glassdoor. On average, nurse practitioner jobs with insurance companies make slightly less than NPs who work in-patient or specialty areas
such as cardiology.
As you can see from the different NP jobs listed above, there is a wide variety of job types for nurse practitioner insurance jobs. Some pay much more than others. If top pay is what you are seeking, you should look into insurance positions that are more “hands-on” vs. primarily paperwork. It seems that the jobs that are more involved with patient interaction tend to compensate their NPs at a higher wage.
Is There A Demand For Nurse Practitioner Insurance Jobs?
There is a demand for nurse practitioners in all positions. With the exodus of medical professionals from inpatient positions, insurance jobs for nurse practitioners are filling fast. As a potentially remote job, nurse practitioner jobs with insurance companies are not as plentiful as prior to the Covid pandemic. Currently, virtual and non-clinical setting NP positions are in higher demand than previously.
Now is the best time to make a career move if you are considering a job with an insurance company before the market gets saturated.
My Final Thoughts
If you read this article to further investigate NP careers with insurance companies, I hope that I have answered the question of what are the best nurse practitioner insurance jobs? As you can see from this feature about the 10 best nurse practitioner jobs with insurance companies in 2023, there are many unique positions to consider. Personally, I enjoyed a break from inpatient nursing during my years as a case manager. I have always said the beauty of being a nurse is the variety of available jobs for nurses. In nursing, there is no reason to stay in a position where you are unhappy. And insurance nursing is certainly a breath of fresh air for those seeking a career change. I wish you the best in your potential career move!
FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT
What Is The Highest Paying NP Insurance Job?
As discussed above, NP insurance jobs that involve direct patient interaction pay the most. Larger corporations also tend to pay higher than smaller companies. In addition, as in other health environments, psychiatric nurse practitioners can command higher wages due to the increased demand for this specialty.
Are NP Insurance Jobs Remote In Nature?
In general, insurance NP positions tend to be more remote than many other NP jobs. Once again, an NP's environment is variable and dependent on the insurance company's type of job. Work that involves mainly paperwork tends to allow their NPs to work at home more than other positions.
How To Find A Good NP Insurance Job?
I have placed numerous links to jobs in the content of this article. (Look under the section of “what are the best insurance companies to work for”.) That is an excellent place to start. Also, googling job boards such as indeed.com
with a heading of “nurse practitioner case manager” is another way to find local and remote NP insurance positions.
Are NP Insurance Jobs Part-Time OR Full-Time?
The majority of NP insurance jobs are full-time. However, there are “assessment” positions for NPs that are paid “per patient assessment”. These types of jobs can be part-time.
What Type of Nurse Practitioner is Best Suited for Insurance Jobs?
Typically, NPs with a “generalist” background are best suited for insurance jobs. FNPs would be a first choice as their training spans all of the life periods. Since much of insurance work involved those on Medicare, adult nurse practitioners and those with gerontology backgrounds would be great candidates for insurance positions that deal primarily with the adult population.
Are There Any Insurance Jobs for Specialty NPs?
As mentioned previously, Molina Health has a large national contract with the State Children Health Insurance Plan. Pediatric NPs would be in demand for this type of insurance case management. In addition, there are insurance programs that support “mom and baby” in which nurse practitioners certified in women’s health could lend much expertise.
Donna Reese MSN, RN, CSN
Donna Reese is a freelance nurse health content writer with 37 years nursing experience. She has worked as a Family Nurse Practitioner in her local community clinic and as an RN in home health, rehabilitation, hospital, and school nursing.