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

Job Overview

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Employment Type

Full-time
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Compensation

Salary
Range $66,575.00 - $142,576.00
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Work Schedule

Standard Hours
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Benefits

Medical insurance
Dental Insurance
Vision Insurance
Paid Time Off
retirement savings plan
wellness programs
Mileage reimbursement

Job Description

CVS Health is a leading healthcare company committed to building a world of health around every individual. The organization focuses on creating a connected, convenient, and compassionate health experience, driven by a team of passionate colleagues who prioritize innovation, accountability, safety, and quality in all they do. CVS Health serves millions of customers and patients through its diverse portfolio of health services, retail pharmacies, and health insurance products, fostering improved health outcomes and well-being in communities nationwide. As one of the most respected companies in the healthcare industry, CVS Health offers comprehensive services that span from pharmacy benefit management to health insurance and retail health clinics. The company's mission is deeply rooted in simplifying health care one person, one family, and one community at a time, emphasizing the importance of personalized care and support for every individual they serve.

The position is for a Case Manager within the Aetna team, a division of CVS Health that leads in serving dual eligible populations—members enrolled in both Medicare and Medicaid. This role holds the opportunity to make a life-changing impact on members who face complex health and social challenges. Through compassionate attention and excellent communication skills, the Case Manager collaborates extensively with members, healthcare providers, and community organizations. The goal is to address the comprehensive healthcare needs and social determinants that affect these populations. This role requires leveraging best-in-class operating and clinical models to deliver exceptional patient care and outcomes. Case Managers are responsible for a collaborative process that includes assessment, planning, facilitation, coordination, evaluation, and advocacy to meet the comprehensive health needs of individuals and families. Through this process, the Case Manager promotes quality, cost-effective outcomes and supports integration of care and community resources.

This is a full-time position based in Cook County, Illinois, with a typical workweek of 40 hours. The role requires a Registered Nurse (RN) with an active and unrestricted license in Illinois, who brings a minimum of three years of clinical practical experience and two years of proficient computer skills including MS Office suite. The Case Manager must be willing and able to travel up to 50% of the time within Cook County, with mileage reimbursed in accordance with company policy. Strong analytical, problem-solving, organizational, interpersonal, and communication skills are essential for success. Preferred qualifications include Certified Case Manager credential and experience in case management, discharge planning, or home health care coordination. Education requirements include at least an associate’s degree in nursing, with a bachelor’s degree preferred.

Compensation for this role ranges from $66,575 to $142,576 annually, reflecting base salary depending on experience, education, geography, and other relevant factors. Additionally, the position is eligible for CVS Health bonus, commission, or short-term incentive programs. Benefits are comprehensive, supporting the physical, emotional, and financial well-being of employees and their families, including medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs. CVS Health fosters an inclusive workplace culture committed to diversity, equity, and belonging, ensuring every team member feels valued and empowered to contribute to the company's mission. This is an exciting opportunity to join a respected healthcare leader and make a meaningful impact on vulnerable populations through collaborative, compassionate case management.

Job Requirements

  • Candidate must reside within or be willing to travel to Cook County, Illinois
  • Must possess reliable transportation and willingness to travel up to 50% of the time within Cook County (mileage reimbursed)
  • Active and unrestricted Registered Nurse (RN) license in Illinois
  • Minimum 3 years clinical practical experience as a Registered Nurse
  • At least 2 years experience using computers and MS Office suite
  • Confidence working independently and with virtual collaboration tools
  • Excellent analytical, problem-solving, organizational, communication, and interpersonal skills
  • Ability to work independently

Job Qualifications

  • Active and unrestricted Registered Nurse (RN) license in Illinois
  • Minimum of 3 years clinical practical experience as a Registered Nurse
  • At least 2 years experience using personal computers and Microsoft Office applications
  • Strong analytical and problem-solving skills
  • Effective communication, organizational, and interpersonal skills
  • Ability to work independently
  • Certified Case Manager credential (preferred)
  • Experience in case management, discharge planning, or home health care coordination (preferred)
  • Associate’s Degree in Nursing required
  • Bachelor’s Degree in Nursing preferred

Job Duties

  • Act as a liaison with members, clients, families, employers, providers, insurance companies, and healthcare personnel as appropriate
  • Implement and coordinate all case management activities relating to catastrophic cases and chronically ill members across the continuum of care including referrals, home visits, and community resource utilization
  • Interact with members telephonically or in person, including home, worksite, or physician office visits to provide ongoing case management
  • Assess and analyze medical and vocational status of members, develop individualized plans of care to optimize wellness, medical outcomes, and timely return to work or function
  • Communicate effectively with members, clients, and other stakeholders
  • Document all case work activities accurately and timely
  • Collaborate with internal multidisciplinary teams to maximize health outcomes
  • Conduct outreach to treating physicians or specialists regarding course of care and treatment
  • Provide educational and preventative information for best medical outcomes
  • Ensure compliance with laws, regulations, insurance requirements, and company policies
  • Evaluate member needs and benefit plan eligibility and facilitate integrative functions using clinical tools
  • Utilize case management processes in accordance with regulatory and company guidelines
  • Facilitate appropriate condition management to optimize wellness and return to baseline
  • Develop proactive plans to enhance short and long-term outcomes and promote overall wellness
  • Monitor and evaluate member progress toward desired outcomes

Job Criteria

Experience

Mid Level (3-7 years)


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