Case Management Nurse I (Remote Eligible)

We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Use Your Strengths as a Case Management Nurse I at Wellmark! About the role: As a Case Management Nurse I, you will serve as a key advisor who actively engages with members through a variety of channels to foster a caring and trusting level of connection in order to support their chronic and/or complex health care needs and concerns. You will create and manage unique, individualized care plans that ensure the best possible health care goals and complex health needs are reasonably met. You will partner with members, members’ families, health care providers and community resources to coordinate and facilitate care and services. Remote Eligible: You will have the flexibility to work where you are most productive. This position is eligible to work fully remote. Depending on your location, you may still have the option to come into a Wellmark office if you wish to. Your leader may ask you to come into the office occasionally for specific meetings or other ‘moments that matter’ as well.

Must be flexible and have the ability work weekend and/or holiday hours when needed on a rotational basis. Utilize critical thinking to recognize signs and symptoms of potential high-risk and complex conditions that warrant different or greater levels of support and proactively anticipate member needs in the navigation of the health care system and the benefits and resources available. Discuss the care needs with the member through supportive, focused intervention methods and effective planning techniques. Proactively identify barriers and gaps to care while designing, creating, and managing unique, individualized care plans that ensure members/providers have good communication channels, that members receive appropriate care, that potential duplication of services is avoided, and education is provided to help enable them to achieve the best possible health care goals. Partner with members, members’ families, health care providers and community resources to coordinate and facilitate the care and services needed. Actively engage members as participants in their unique care management plan and educate on their personal accountabilities and expected outcomes. Advise on included benefits and services that are appropriate for their current medical status, and how those benefits and services can positively impact not only their medical status, but also the total cost of care. Stay curious and engaged by actively continuing to partner with other members of the Wellmark Team and research appropriate resources and/or programs as science and technology evolves, that may help to improve the health of assigned members going forward. Continue collaborative efforts with other clinical and nonclinical stakeholders, both internal and external to Wellmark, to provide optimal service and meet the needs of the member and coordinate care. Facilitate additional referrals to providers, community resources/programs, and specific Wellmark programs, as necessary. Using relevant technology tools, document care management activities accurately, consistently, and timely by following the standard work guidelines and policies to support internal and external processes. Comply with regulatory standards, accreditation standards and internal guidelines. Remain current and consistent with the specific standards pertinent to the Care Management team. Other duties as assigned.