Analyst, Case Mgt Field

4004 Aetna Medicaid Administrators; Illinois; On-site; USD 60,460,000 - 128,914,000; Full time

Benefits offered by this job

Benefits package

Job summary

4004 Aetna Medicaid Administrators is seeking a Field-based Analyst, Case Management LTSS in Rock Island County, IL. The role requires traveling 50-75% and quarterly in-person member visits, handling full caseloads and coordinating care plans.

You will evaluate member needs, coordinate services, and advocate for appropriate care using available tools and resources. A bachelor’s or master’s in human services is preferred, with at least two years of experience.

Qualifications

• Bachelor’s degree or Master’s in a human-services field.
• Minimum of two years of case management experience.
• Experience with Microsoft Office and electronic health records.

Responsibilities

• Evaluate referred members’ needs and eligibility and plan case resolution.
• Coordinate and monitor care plan activities and progress.
• Escalate quality of care issues and collaborate with care teams.
• Provide coaching and support to empower informed healthcare decisions.

Skills

Case management experience

Communication skills

Microsoft Office

Education

Bachelor’s degree in human services

Master’s degree in human services

Tools

Microsoft Office

Electronic health records

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 Analyst, Case Management Field position is with Aetna’s Long Term Services & Supports (LTSS) team and is a field-based position out of the Rock Island County area of Illinois. The requirement is for candidates to travel 50-75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meet contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.

Evaluation of Members

• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members’ needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members’ benefit plan and available internal aid and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care

• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care

• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

• Must reside in the state of Illinois in Rock Island area
• Valid Illinois Driver’s license
• Willing and able to travel up to 75% of their time to meet with members face to face
• Reliable Transportation required, eligible for mileage reimbursement as per company policy.
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience
• NOTE: If position is intended to manage HIV/AIDs HCBS Waiver members, It is mandatory that individuals have experience in working with racial and ethnic minorities, as well as one or more of the following: domestic abuse; the lesbian, gay, bisexual, transgender, queer (LBGTQ+) community; Persons living with HIV/AIDS Persons with substance use disorders.

Preferred Qualifications

• Case management and discharge planning experience preferred
• Managed Care experience preferred
• Microsoft Office experience preferred

Education

Individual with a bachelor’s degree or a non‑licensed individual with a master’s degree, with either degree being in a human‑services field (including, but not limited to sociology, special education, rehabilitation counseling)

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.

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.

Application Window Close Date

We anticipate the application window for this opening will close on: 10/16/2026

EEO Statement

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

Our Work Experience

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.