Case Management Analyst - Field in Macon County Illinois

CVSHealth; Springfield (IL); On-site; USD 29,000 - 62,000; Full time

Benefits offered by this job

Mileage reimbursement

Comprehensive benefits

Job summary

CVS Health is seeking a Field-based Case Management Coordinator for the LTSS team in Macon County, IL. The role requires 50-75% travel to meet members face to face and deliver care coordination, support and education using care management tools and resources.

The position emphasizes evaluating member needs, coordinating care plans, and escalating quality issues while empowering members to participate in health decisions.

Qualifications

• Minimum 2 years of experience in behavioral health or human services field.
• Minimum 2 years of case Management experience.
• Must reside in Macon County IL.
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet members face to face in Macon County, and surrounding areas. Mileage is reimbursed per our company expense reimbursement policy
• Active Drivers License, preferably out of IL.

Responsibilities

• Evaluate referred member’s needs/eligibility and determine approach to case resolution.
• Coordinate and monitor care plan activities.
• Enhance quality of care by consulting with case managers, supervisors and Medical Directors to overcome barriers.
• Identify and escalate quality of care issues.
• Use negotiation skills to secure appropriate options and services for member benefits and healthcare needs.
• Provide coaching and support to empower members to make independent medical and healthy lifestyle choices.
• Help members participate with their provider in healthcare decision-making.
• Monitor, evaluate and document care in compliance with regulatory and company policies.

Skills

Case management

Care coordination

Interpersonal skills

Driver's license

Education

Bachelor's degree or non-licensed master's in behavioral health or human services

Tools

Microsoft 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 Case Management Coordinator position is with Aetna’s Long-Term Services and Supports (LTSS) team and is a field-based position out of the Macon County. The requirements is for candidates to travel 50-75% of the time to meet with members face to face.

As a Case Management Coordinator you will facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Travel: 50-75% travel required.

• Evaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal 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

• Minimum 2 years of experience in behavioral health, social services or human services field.
• Minimum 2 years of case Management experience.
• Must reside in Macon County IL
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet members face to face in Macon County, and surrounding areas. Mileage is reimbursed per our company expense reimbursement policy
• Active Drivers License, preferably out of IL

Preferred Qualifications

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

Education

• Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (psychology, social work, marriage and family therapy, 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.

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: 11/27/2026

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