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

CVS Health•Field Township, IL

6d•$66,575 - $142,576•Remote

About The Position

CVS Health’s Aetna program serves people enrolled in both Medicare and Medicaid who may face complex medical, behavioral, and social challenges. The Care Manager RN uses a collaborative, member-centered approach to assess, plan, coordinate, implement, monitor, and evaluate healthcare services. The role partners with members and their families to address comprehensive health needs, facilitate access to resources, and promote quality, cost-effective outcomes. The Care Manager develops and implements individualized care plans to support wellness, optimize clinical outcomes, and help members receive appropriate benefits, services, and support to achieve their health goals. The position involves telephonic engagement and in-person visits in members’ homes, provider offices, or community settings as needed. It is based in a remote home-work setting, with required travel to serve members in Cook County and surrounding areas. The role requires an Illinois RN license, residence in Cook County, reliable transportation, and willingness to travel up to 50–75% of the time. The position is full-time, with 40 anticipated weekly hours. The stated pay range is $66,575–$142,576, with potential eligibility for a CVS Health bonus, commission, or short-term incentive program. A comprehensive benefits package is available based on eligibility.

Requirements

Must reside in Cook County and be able to serve members in Cook County and surrounding areas.
Active and unrestricted Registered Nurse license in Illinois.
Reliable transportation and willingness and ability to travel up to 50–75% of the time; mileage is reimbursed under the company expense reimbursement policy.
Minimum of 3–5 years of clinical nursing experience.
Minimum of 2–3 years of experience in case management, discharge planning, care coordination, or home health.
Strong clinical assessment, critical thinking, and problem-solving skills.
Excellent communication, organizational, and interpersonal skills.
Ability to work independently and effectively in a remote environment.
Comfort using technology to collaborate virtually with interdisciplinary teams.
Associate or bachelor’s degree in nursing from an accredited institution.
Ability to meet work-from-home requirements, including a direct/hardwired internet connection with at least 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted.
A quiet, secure, private, organized home workspace compliant with CVS Health and HIPAA guidelines, allowing uninterrupted work during work hours.
Must work from within the state and city where the employee has confirmed they currently live.
Must provide workspace furniture, such as a desk or standing desk, and commit to meeting required internet speeds and work-from-home requirements.
Comfort setting up and using multiple monitors and navigating multiple applications simultaneously.
Ability to use digital communication channels such as email, calendar invites, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
Ability to access secure systems, follow security practices, and troubleshoot common technical issues or contact IT for unresolved issues.
Openness to learning new skills as the workplace environment evolves.

Nice To Haves

Certified Case Manager (CCM) certification.
Experience working with Medicare, Medicaid, or dual-eligible populations.
Experience addressing social determinants of health and coordinating community-based services.

Responsibilities

Serve as a liaison among members, families, providers, employers, health plans, community organizations, and other stakeholders.
Coordinate and manage care activities for members with complex, chronic, catastrophic, or acute health conditions across the continuum of care.
Conduct comprehensive assessments of medical, functional, psychosocial, and environmental needs.
Develop, implement, and monitor individualized care plans to improve health outcomes and support member wellness.
Facilitate access to healthcare services, community resources, home health services, and alternative levels of care.
Engage with members by telephone and through in-person visits in homes, provider offices, or community settings as needed.
Collaborate with interdisciplinary care teams to support coordinated, evidence-based care.
Communicate with providers, members, caregivers, and other stakeholders about treatment plans, progress, and care needs.
Educate members and families about disease management, prevention strategies, available benefits, and community resources.
Conduct outreach to treating physicians, specialists, and other providers to support care coordination and treatment planning.
Monitor member progress and adjust care plans as needed to achieve desired outcomes.
Maintain accurate and timely documentation in accordance with organizational, regulatory, and accreditation requirements.
Ensure compliance with applicable laws, regulations, policies, and case management standards.
Promote health outcomes, functional independence, and quality of life through proactive intervention and advocacy.