Analyst Case Management - Field in DuPage County or Western Cook County Illinois

4004 Aetna Medicaid Administrators; Illinois; On-site; USD 29,000 - 62,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an Analyst Case Manager. This field-based role requires 50-75% travel to meet members face-to-face in Chicago IL and surrounding areas. Candidate should live in DuPage County or Western Cook County, IL.

Schedule is Monday–Friday, 8:00am–4:30pm CST, with emphasis on assessing and coordinating member care to promote wellness. You will work with clinical resources, apply judgment to reduce risk, and ensure compliant case management while traveling.

Qualifications

• Must reside in DuPage County or Western Cook County IL or Surrounding Areas
• Minimum 2 years of Case Management practice experience required
• Minimum 1 year experience in MS Office Suite applications
• Willing and able to travel 50-75% of time to meet members in Chicago IL and surrounding areas

Responsibilities

• 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 overall wellness through integration.
• Services strategies policies and programs are comprised of network management and clinical coverage policies.
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.

Skills

Case Management

Interpersonal skills

Clinical assessment

Communication

Education

Bachelor's Degree

Non-licensed Masters degree

Tools

MS Office

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.

Position Summary

This is a field-based position with expected travel of 50-75% to meet with members face to face in Chicago IL or Surrounding Areas. Candidate to live in DuPage county or Western Cook county. Schedule is Monday-Friday, standard business hours, 8:00am-4:30pm CST. Analyst Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Key Responsibilities

• 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 overall wellness through integration.
• Services strategies policies and programs are comprised of network management and clinical coverage policies.
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member’s level of work capacity and related restrictions/limitations.
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications

• Must reside in DuPage County or Western Cook County IL or Surrounding Areas
• Minimum 2 years of Case Management practice experience required
• Minimum 1 year experience in MS office suite applications.
• Willing and able to travel 50-75% of their time using their own vehicle to meet members face to face in Chicago IL and surrounding areas. Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

• Case Management in an integrated model preferred.
• Experience working with adults with Behavioral Health needs preferred.
• Long Term care experience in Nursing Home setting preferred

Education

• Bachelors Degree required, preferably in social work, psychology, nursing, human services, or related field.
• Non-licensed Masters degree preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $21.10 - $44.99 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.

Benefits

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.

Application Deadline

We anticipate the application window for this opening will close on: 12/07/2026

Company Culture

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.