Let’s get started
By clicking ‘Next’, I agree to the Terms of Service
and Privacy Policy, and consent to receive emails from Rise
Jobs / Job page
Case Manager, Registered Nurse (Field - Bureau County, IL) image - Rise Careers
Job details

Case Manager, Registered Nurse (Field - Bureau County, IL)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

 This Case Manager, Registered Nurse position is with Illinois Medicare/Medicaid Plan team and is a field-based position. Candidates from Illinois are welcome to apply, however, requirement is for candidates to hold an active Registered Nurse License in IL. 

Position Summary

Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

Family Summary/Mission

Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.

Position Summary/Mission

Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Fundamental Components & Physical Requirements

  • Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.

  • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
  • Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
  • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
  • Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
  • Prepares all required documentation of case work activities as appropriate.
  • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
  • May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
  • Provides educational and prevention information for best medical outcomes.
  • Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
  • Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
  • Utilizes case management processes in compliance with regulatory and company policies and procedures.
  • Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
  • Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration.
  • Monitors member/client progress toward desired outcomes through assessment and evaluation.

Required Qualifications

  • Must reside in Bureau County, IL and able to travel throughout the surrounding counties as needed to meet business needs and support in-person case management activities
  • Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy
  • Must have an active and unrestricted Registered Nurse (RN) license in the state of Illinois
  • 3+ years clinical practical experience
  • 2+ years care management, discharge planning and/or home health care coordination experience

Preferred Qualifications

  • Certified Case Manager
  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Ability to work independently
  • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
  • Efficient and effective computer skills including navigating multiple systems and keyboarding

Education

  • Associate's Degree in Nursing (REQUIRED)
  • Bachelor's Degree (PREFERRED)

Certification

  • Active and unrestricted Registered Nurse (RN) License in the state of Illinois

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,575.00 - $142,576.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/16/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
CVS Health Glassdoor Company Review
3.1 Glassdoor star iconGlassdoor star iconGlassdoor star icon Glassdoor star icon Glassdoor star icon
CVS Health DE&I Review
No rating Glassdoor star iconGlassdoor star iconGlassdoor star iconGlassdoor star iconGlassdoor star icon
CEO of CVS Health
CVS Health CEO photo
Karen S. Lynch
Approve of CEO

Average salary estimate

$104575.5 / YEARLY (est.)
min
max
$66575K
$142576K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

Similar Jobs
Photo of the Rise User
Posted 9 days ago

As an Outreach Executive at Oak Street Health, you'll drive patient acquisition by building strategic community relationships in a transformative healthcare organization.

Photo of the Rise User
Posted 9 days ago

Step into a rewarding Sales Associate role at CVS Health and contribute to transforming healthcare through effective nutrition service sales.

Become a key player in Huntington's commitment to customer service as a Customer Experience Banker in Chicago.

Posted 9 days ago

Join Deutsche Bank's AFC team to provide essential L3 support while ensuring the stability and performance of critical banking applications.

Join Carenet Health as a remote Healthcare Customer Service Representative and make a positive difference in patients' lives!

Elevate your career as a Remote Call Center Sales Representative with MCI, a leader in Business Process Outsourcing.

Photo of the Rise User

Become a vital part of our team as a Patient Service Specialist, enhancing patient experiences in our Fort Myers center.

Photo of the Rise User

Join LegalMatch Philippines as a Consultation Appointment Specialist to enhance client engagement and streamline legal consultation scheduling remotely.

Photo of the Rise User

BenchPrep is looking for a Remote Customer Success Manager to foster client relationships and drive product adoption on its innovative learning platform.

Photo of the Rise User
Posted 12 hours ago

Become a vital part of DevRev as a Customer Success Manager, guiding clients through their journey with our groundbreaking AI-driven platform.

Photo of the Rise User

Truist seeks a dedicated Brokerage Registered Client Service Associate in Charleston to enhance Financial Advisors' client servicing capabilities.

Photo of the Rise User

U.S. Bank is looking for Client Relationship Consultants to strengthen client relationships and enhance their financial experiences in Rancho Santa Fe, CA.

Photo of the Rise User
Nagarro Hybrid New York City, New York, New York, United States
Posted 14 days ago

Join our innovative Digital Product Engineering company as an Associate Engineer - IT Help Desk Agent, where customer service excellence is at the forefront.

Penn Lumbermens Mut Ins Co Hybrid Philadelphia, Pennsylvania, United States
Posted 9 days ago

Become a vital part of Pennsylvania Lumbermens Mutual Insurance Company as a Customer Service Representative, where you'll assist policyholders and brokers in navigating their insurance needs.

Fiserv Hybrid Berkeley Heights, New Jersey
Posted 10 days ago

Make a global impact as a Customer Success Manager at Fiserv, supporting high-value client relationships in the Fintech space.

We help people with their health wherever and whenever they need us. And we do it with heart. Because our passion is our purpose: Bringing our heart to every moment of your health™.

1270 jobs
MATCH
Calculating your matching score...
BADGES
Badge ChangemakerBadge Flexible CultureBadge Future Maker
FUNDING
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
EMPLOYMENT TYPE
Full-time, on-site
DATE POSTED
April 17, 2025

Subscribe to Rise newsletter

Risa star 🔮 Hi, I'm Risa! Your AI
Career Copilot
Want to see a list of jobs tailored to
you, just ask me below!
LATEST ACTIVITY
Photo of the Rise User
Someone from OH, Dayton just viewed Plant Engineer I - HVAC at Pfizer
Photo of the Rise User
Someone from OH, Dayton just viewed Entry Level Industrial Engineer at Boeing
Photo of the Rise User
Someone from OH, Dayton just viewed Manufacturing Engineer Intern at Marvin
Photo of the Rise User
Someone from OH, Dayton just viewed Assessment Engineering Intern at Learning A-Z
C
Someone from OH, Dayton just viewed Project Engineer at CRB
Photo of the Rise User
Someone from OH, Dayton just viewed Manufacturing Engineer III at Agile Space Industries
Photo of the Rise User
8 people applied to Cashier (Part-time) at Datadog