Case Manager, Registered Nurse – Field - Cook County, IL

CVS Health is a leading health solutions company dedicated to building a world of health around every individual. With a strong commitment to creating a more connected, convenient, and compassionate health care experience, CVS Health serves millions of customers across the United States through its extensive network of pharmacies, retail locations, and health services. The company places a high priority on innovation, accountability, safety, and quality, ensuring that every interaction with its customers is driven by care and expertise. As a part of CVS Health, employees are empowered to make a difference in the lives of individuals, families, and communities by simplifying health care and promoting healthier outcomes.

The Aetna team, a division within CVS Health, is focused on serving dual eligible populations—individuals enrolled in both Medicare and Medicaid—who face complex health and social challenges. This team utilizes best-in-class operating and clinical models to provide comprehensive patient care that targets both medical and social determinants of health. This role offers an exciting opportunity to make a life-changing impact not only through clinical expertise but also through collaboration with providers, community organizations, and the members themselves.

The Case Manager position within the Aetna team is pivotal in elevating patient care by leveraging a collaborative process that includes assessment, planning, facilitation, care coordination, evaluation, and advocacy. This role demands a compassionate approach combined with excellent communication skills to effectively address the full continuum of members' health care needs. Responsibilities include liaising with clients, families, providers, and insurance companies, coordinating case management activities for catastrophic and chronically ill members, and ensuring a smooth continuum of care across various settings.

Case Managers will engage directly with members through various methods, including telephonic and in-person meetings, potentially visiting homes, worksites, or physician offices to provide ongoing support. By analyzing the medical and vocational statuses of clients, case managers develop individualized plans aimed at optimizing wellness, medical outcomes, and timely return to work or optimal functioning. The role also involves working with interdisciplinary teams, conducting outreach to treating physicians, providing educational resources, and ensuring compliance with all applicable laws and insurance guidelines.

This full-time role requires a dedicated professional residing in or willing to travel frequently to Cook County, Illinois. The typical weekly hours amount to 40 with a competitive pay range from $66,575.00 to $142,576.00 annually. Additionally, candidates may be eligible for bonuses or incentive programs. CVS Health is committed to diversity and inclusion, valuing every team member's contribution and fostering a workplace where everyone feels valued and belongs.

Comprehensive benefits accompany this position, emphasizing support for physical, emotional, and financial well-being. The benefits package includes medical, dental, and vision insurance, paid time off, retirement savings options, wellness programs, and additional resources to support the employee and their family. CVS Health continuously invests in its workforce, providing opportunities for career growth and personal development in a dynamic and rewarding environment dedicated to transforming health care.