Case Manager - Registered Nurse – Field – Swedish American Hospital + $10,000 New Hire Bonus

CVS Health • Chalmers, IL

9d • Onsite

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Program Overview Help us elevate patient care to a whole new level. Join the Aetna Clinical Collaboration (ACC) team - an innovative and growing, community‑based care management model designed to transform how we serve our members. ACC utilizes best‑in‑class clinical and operating models to deliver meaningful, high‑impact care where it matters most. ACC is a member‑centric, team‑delivered approach that meets members where they are. Through compassionate engagement and strong communication, our care teams collaborate with members, providers, and community organizations to address the full continuum of healthcare needs, including medical, behavioral, and social determinants of health. This is an exciting opportunity to be part of a growing program with national expansion, offering the chance to help shape care delivery in new markets and have a life‑changing impact on the members we serve. Family Summary/Mission This role supports the delivery of appropriate benefits and healthcare services by facilitating eligibility determination, promoting wellness activities, and advancing successful, timely health outcomes. The team develops, implements, and supports health strategies, policies, and programs that ensure effective care delivery and overall member wellness. Services span network management, clinical coverage, and evidence‑based policies. Position Summary/Mission The ACC Case Manager applies a collaborative, member‑centered approach to assessment, care planning, coordination, evaluation, and advocacy to address the comprehensive health needs of individuals and families. This is an on‑site, hospital‑based role supporting members receiving care at Swedish American Hospital and requires consistent in-person engagement with members, providers, and multidisciplinary care teams. Candidates must reside within reasonable driving distance of the facility to support reliable on‑site presence and timely care coordination.

Requirements

• Candidate must have active and unrestricted Illinois Registered Nurse (RN) License
• 3+ years of clinical experience, preferably with Medicare and Commercial populations
• Ability to work independently within a hospital‑based environment
• Strong analytical, problem‑solving, organizational, and communication skills
• Proficiency in MS Word, Excel, Outlook, PowerPoint, and proprietary clinical systems
• Efficient computer skills, including navigating multiple systems and keyboarding
• Reliable transportation and the ability to consistently meet on‑site, hospital‑based work requirements at Swedish American Hospital
• Associate’s Degree in Nursing with equivalent clinical experience (REQUIRED)

Nice To Haves

• 1+ year(s) of experience in care management, discharge planning, or home health coordination
• Willingness to obtain multi‑state RN licensure (company supported)
• National certification (CRC, CDMS, CRRN, COHN, or CCM)
• Bachelor's Degree in Nursing (PREFERRED)

Responsibilities

• Serve as a liaison between members/clients, families, employers, providers, insurance carriers, and healthcare personnel as appropriate.
• Implement and coordinate case management activities for catastrophic and chronically ill members across the continuum of care, including consultant referrals, home care, community resources, and alternative levels of care.
• Interact with members/clients both telephonically and in person while working on‑site at Swedish American Hospital, including meeting with members during inpatient admissions.
• Assess medical, functional, and vocational status to develop and implement individualized plans of care that support optimal health outcomes, benefits eligibility, and timely return to work or baseline functioning.
• Communicate effectively with stakeholders including medical providers, attorneys, employers, and insurance carriers.
• Prepare timely and accurate documentation of all case management activities.
• Collaborate with internal multidisciplinary teams to support optimal member outcomes.
• Conduct outreach to treating physicians and specialists to support appropriate care planning.
• Provide education and preventive guidance to promote best clinical outcomes.
• Apply applicable laws, regulations, and payer requirements related to rehabilitation and case management services.
• Monitor member progress toward desired outcomes and adjust care plans as needed.
• Develop proactive strategies to address complex needs and support both short‑ and long‑term wellness outcomes.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees