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23 Wellmark Utilization Management Nurse Jobs Hiring Near You

Quality Engineer III

Des Moines, IA · On-site

$70.30K - $90.80K/yr

Why Wellmark Technology? Wellmark is building innovative, modern solutions using cutting edge ... Strong time management and organizational skills * Proven ability and interest in mentoring ...

Why Wellmark Technology? Wellmark is building innovative, modern solutions using cutting edge ... Strong time management and organizational skills * Proven ability and interest in mentoring ...

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Wellmark Jobs Information

What are the key skills and qualifications needed to thrive as a Utilization Management Nurse, and why are they important?

To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.

What are some common challenges a Utilization Management Nurse faces when coordinating care between providers and insurance companies?

A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.

What is a Utilization Management Nurse?

A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.

What is the difference between Utilization Management Nurse vs Case Manager?

AspectUtilization Management NurseCase Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community health agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What is it like to work at Wellmark?

Wellmark is a company that values collaboration and teamwork, fostering a supportive and inclusive work environment where employees can grow professionally and personally.

As a health insurance company, Wellmark's mission is to improve the health and well-being of its members, and its team structure reflects this focus, with various departments working together to develop and implement innovative solutions. The company's work environment is designed to promote flexibility and work-life balance, with options for remote work and a range of employee benefits.

Working at Wellmark may appeal to candidates who are passionate about healthcare and want to make a positive impact on their community, as the company offers opportunities for professional growth and development in a dynamic and supportive team environment.
What are the most popular categories at Wellmark?
Infographic showing various Utilization Management Nurse job openings at Wellmark in the United States as of May 2026, with employment types broken down into 98% Full Time, and 2% Nights. Highlights an 76% Physical, 17% Hybrid, and 7% Remote job distribution.
Associate Product Owner (Open to hiring Product Owner)

Associate Product Owner (Open to hiring Product Owner)

Wellmark, Inc.

Des Moines, IA • On-site

$24/hr

Full-time

Posted 29 days ago


Job description

Company Description
Why Wellmark?
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!
Learn more about our unique benefit offerings here.
Want to know more? You can learn about life at Wellmark here.
Why Wellmark Technology? Wellmark is building innovative, modern solutions using cutting edge technology. We are driving organizational transformation and business strategy by empowering our technology team to innovate new and elegant solutions to enhance the customer experience. Together, we are leaning into the future, owning the outcome, and driving organizational change to transform how we work.
Job Description
The Associate Product Owner is responsible for maximizing the product's value and the agile team's work by ensuring the team's backlog is prioritized and aligned with customer needs and approved business cases. Builds strong partnerships with stakeholders through continuous communication and feedback to ensure their needs are represented and the product outcomes are achieved. Develops and conveys the product's vision to the agile team, outlining and prioritizing work based on business value realization metrics.
Qualifications
Required:
  • Bachelor's degree or direct and applicable work experience.
  • Minimum 3+ years' experience in a combination of:
  • Proven project management experience including managing project scope and schedule, utilizing industry standard project management methodologies.
  • Eliciting detailed business requirements.
  • Experience in a change management capacity aligned to an industry standard methodology.
  • Exposure to the development and execution of user acceptance test plans, scenarios, and cases utilizing industry standard testing methodologies.
  • Wellmark business acumen for specific product or division of this role.
  • Demonstrates ownership and commitment to projects; drives tasks and milestones toward successful completion and holds themselves accountable for project performance.
  • SAFe agile certification (e.g., Product Owner) obtained within 3 months.
  • Possess or is willing to pursue certified Product Owner Certification.
  • Experience successfully leading others through change.
  • Demonstrated facilitation and influencing skills to drive decision making among stakeholders with diverse perspectives and priorities.
  • Ability to work well in a team environment and be capable of building and maintaining relationships with other team members, departments, and customers.
  • Demonstrated ability to communicate complex information in a condensed manner to various stakeholders verbally and in writing to achieve shared vision and goals.
  • Strong problem solving and analytical skills.
  • Ability to identify risks and deploy appropriate mitigation strategies to meet stakeholder/functional requirements.
  • Strong group facilitation skills and presentation skills demonstrated through successful experience.
  • Consulting skills required with, excellent communication, collaboration, and interpersonal skills.
  • Proficient in Microsoft Office suite.
  • Software Development Lifecycle (SDLC) knowledge.

Preferred:
  • Bachelor's degree.
  • Prior experience in a Product Owner role operating within a SAFe organization, including demonstrated experience with agile and/or lean product management competencies of value measurement, optimization, and eliminating waste.
  • Experience with agile business analysis, including documentation of features, user stories, and acceptance criteria.
  • Exposure to negotiation skills and techniques.
  • Experience using agile requirements management tools (e.g., Jira or Azure DevOps).
  • Health Services / Utilization Management experience

Additional Information
Job Responsibilities
a. Maximize the value of the product and the work of the agile team by working with the team to ensure that they have a clear vision of the priority and value of the work.
b. Act as a strong, informal, dotted-line leader and mentor to the agile team through effective two-way communication, helping employees learn new skills, identifying and managing resistance, and being an advocate.
c. Serve as the voice of the customer by creating a shared understanding of the product vision and customer needs through consistent communications with the team.
d. Active leader in the agile team's scrum events, including agile ceremonies such as stand-ups, story refinements, backlog grooming, and team retrospectives.
e. Lead iteration review meetings to demonstrate the outcomes achieved to the product team's stakeholders or customers.
f. Ensure the team understands the product priorities and executes the highest value work through lean and agile product prioritization methods (e.g, WSJF, MoSCoW).
g. Obtain insights, prioritize, and balance multiple stakeholder priorities, and synthesize complex information, to maintain product team alignment with the vision.
h. Partner with stakeholders and customers to curate the product vision, product stack, and features to ensure that the next increment of value is executed.
i. Author the product roadmap features by creating well-defined product requirements, including features, user stories, and acceptance criteria.
j. Partner with stakeholders to assess value and prioritize features and stories to ensure work focuses on those with a maximum value aligned to the product strategy.
k. Manage against and participate in the refinement of Objectives and Key Results (OKR's) defined for the product team during each planning interval.
l. Evaluate progress at the end of each iteration, including the ability to define Minimum Viable Products (MVP).
m. Seek quantitative and qualitative information to comprehensively understand where the product team's solutions are not optimizing value.
n. Apply change management practices and tools in pre-planning and planning (features and user stories) to ensure impacted stakeholders and employees are prepared and equipped to adopt changes; consult with the Change Practitioner supporting Agile Release Train (ART) to monitor change readiness and adoption across the ART.
o. Understand the impact the assigned product has on the customer and work collaboratively to ensure any change is properly managed.
p. Obtain objective insights through research and analytics to analyze how a customer of the product is adopting, consuming, and benefiting from the product features.
q. Other duties as assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com
Please inform us if you meet the definition of a "Covered DoD official".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants
Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.