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

Job description

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 Aetna, an industry leader in serving dual-eligible populations through best-in-class clinical and operational models. In this role, you will have a meaningful impact on members enrolled in both Medicare and Medicaid who face complex medical, behavioral, and social challenges. Through compassionate support and effective communication, we partner with members, providers, caregivers, and community organizations to address the full spectrum of healthcare and social determinant needs. As we continue to grow and expand into new markets across the country, we invite you to join us in transforming lives and improving health outcomes. Position Summary The Care Manager RN uses a collaborative, member-centered approach to assess, plan, coordinate, implement, monitor, and evaluate healthcare services. This role partners with members and their families to address comprehensive health needs, facilitate access to appropriate resources, and promote quality, cost-effective outcomes. The Care Manager develops and implements individualized care plans that support wellness, optimize clinical outcomes, and ensure members receive the appropriate benefits, services, and support needed to achieve their health goals. Key Responsibilities Serve as a liaison among members, families, providers, employers, health plans, community organizations, and other key stakeholders. Coordinate and manage care activities for members with complex, chronic, catastrophic, or acute health conditions across the continuum of care. Conduct comprehensive assessments to evaluate medical, functional, psychosocial, and environmental needs. Develop, implement, and monitor individualized care plans designed to improve health outcomes and support member wellness. Facilitate access to appropriate healthcare services, community resources, home health services, and alternative levels of care. Engage with members telephonically and through in-person visits in homes, provider offices, or community settings as needed. Collaborate with interdisciplinary care teams to ensure coordinated, evidence-based care. Communicate effectively with providers, members, caregivers, and other stakeholders regarding treatment plans, progress, and care needs. Educate members and families on 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 of case management activities in accordance with organizational, regulatory, and accreditation requirements. Ensure compliance with all applicable laws, regulations, policies, and case management standards. Promote optimal health outcomes, functional independence, and quality of life through proactive intervention and advocacy. Required Qualifications Must reside in Logan County and be able to service members in Logan County and surrounding areas . Active and unrestricted Registered Nurse (RN) license in IL 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. Comfortable use of technology to collaborate virtually with interdisciplinary teams. Ability to travel within an assigned geographic area to conduct in-person member visits and care management activities as needed. Proficiency in Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint, as well as care management and documentation systems. Strong computer skills with the ability to navigate multiple systems simultaneously. Preferred Qualifications Certified Case Manager (CCM) certification. Experience working with Medicare, Medicaid, or dual-eligible populations. Experience in addressing social determinants of health and coordinating community-based services. Education Associate or bachelor’s degree in nursing, bachelor's preferred Work from Home Requirements: • You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted. • A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours. • Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live. • The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time). • If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements. Technical and Logistical Requirements: • Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency. • Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings. • Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace). • Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links. • Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues. • Future Growth: Openness to learning new skills in the future as the workplace environment evolves 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments . We anticipate the application window for this opening will close on: 09/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.