Case Management Nurse I

Wellmark Blue Cross and Blue Shield

Case Management Nurse coordinating individualized care plans for Wellmark, a member-owned health insurer. Supporting complex care needs through education, referrals, documentation, and provider collaboration.

Posted 8/18/2026contractRemote • Cedar Rapids • Iowa • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination and case management, with a strong focus on critical thinking, effective communication, and compliance with healthcare regulations. Proficient in developing individualized care plans and navigating complex health care needs.

Highest-signal resume keywords

Active RN LicenseCertified Case Manager (CCM)4+ Years Clinical ExperienceCare Coordination ExperienceKnowledge of HIPAA Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care NavigationClinical DocumentationUtilization ManagementBehavioral Health ExperienceCritical ThinkingProblem-SolvingIndependent Decision-MakingAccurate DocumentationManaging Multiple PrioritiesTechnical Acumen

Soft Skills

Strong Verbal CommunicationStrong Written Communication

Tools & Technologies

Microsoft OfficeCase Management Platforms

Certifications & Qualifications

Certified Case Manager (CCM)

Industry Keywords

URACNCQAHIPAAPHI Confidentiality StandardsHealth Plan Experience

About the role

Key responsibilities & impact

Engage members through multiple channels to support chronic and/or complex health care needs
Create and manage individualized care plans
Partner with members, families, health care providers, and community resources to coordinate care and services
Use critical thinking to identify high-risk and complex conditions and anticipate member needs
Discuss care needs through supportive interventions and planning techniques
Identify barriers and gaps to care and facilitate appropriate services and referrals
Educate members about accountabilities, expected outcomes, benefits, and services
Research evolving resources and programs and collaborate with Wellmark stakeholders
Document care management activities accurately, consistently, and timely using relevant technology
Comply with regulatory, accreditation, and internal standards
Work weekend and/or holiday hours on a rotational basis when needed
Perform other duties as assigned

Requirements

What you’ll need

Completion of an accredited nursing program
Active and unrestricted RN license in Iowa or South Dakota; must be licensed in the state of residence
Certified Case Manager (CCM), to be obtained within 24 months of hire and maintained throughout the position
4+ years of diverse clinical experience, including 4+ years of direct clinical care to consumers
Care navigation/care coordination experience strongly preferred
Behavioral health experience preferred
Prior health plan experience preferred
Experience in utilization management or a health insurance setting beneficial
Strong verbal and written communication skills
Accurate documentation in case management platforms
Critical thinking, problem-solving, independent decision-making, and ability to manage ambiguity
Ability to organize and manage multiple priorities in a dynamic environment
Strong technical acumen, including Microsoft Office, clinical documentation platforms, and learning new systems
Knowledge of URAC, NCQA, HIPAA, and PHI confidentiality standards and regulations
Flexibility to work weekend and/or holiday hours on a rotational basis when needed
High-speed internet at the remote work location
Applicants must not require immigration sponsorship or additional/permanent work authorization in the United States

Benefits

Comp & perks

Fully remote work eligibility
Flexibility to work where you are most productive
Option to come into a Wellmark office depending on location
Responsible use of AI supported for the workforce and job seekers
Reasonable accommodation support during the application process