Case Management Analyst - Field in Macoupin County & Surrounding Areas , IL

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 and retirement options

Job summary

CVS Health is seeking a Field Case Manager Analyst to support LTSS members in Macoupin County & surrounding areas, IL. The role requires traveling 50-75% to meet members in person and manage a full caseload with quarterly visits.

The ideal candidate has 2+ years in case management, MS Office and EHR proficiency, and a relevant human-services degree. This is a full-time, field-based position with competitive pay and benefits.

Qualifications

• Must reside in Illinois Macoupin County & Surrounding Areas and be able to travel up to 75%.
• Bachelor’s degree or higher in a human-services field (e.g., sociology, rehab counseling).
• Minimum of two years of case management experience; MS Office and EHR experience.

Responsibilities

• Coordinate care and educate LTSS members to optimize health outcomes.
• Evaluate member needs and eligibility; plan care using available resources.
• Identify high-risk factors and refer to clinical case management or crisis services.
• Monitor, document, and report care activities in compliance with regulations.

Skills

Case management

Travel readiness

Communication

Education

Bachelor's degree or higher in human-services field

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

Case Manager Analyst – Field

Location: Macoupin County & Surrounding Areas, IL. Must reside in one of the following Zip Codes.

This Case Management Analyst Field position is with Aetna’s Long-Term Services & Supports (LTSS) team and is a field-based position out of the Macoupin County & Surrounding Areas, IL. 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 meeting contractual requirements.

Job Responsibilities

• 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 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

• Must reside in the state of Illinois Macoupin County & Surrounding Areas, IL.
• Valid Illinois Driver’s license.
• Must possess reliable transportation and be willing and able to travel up to 75% of the time.
• Mileage is reimbursed per our company expense reimbursement policy.
• Minimum of two (2) years of case management experience.
• Microsoft Office and electronic health record experience.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.
• Microsoft Office experience.
• Experience working with HIV and AIDS population.
• Multi-lingual language proficiency.

Required 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.

Benefits

• 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: 10/31/2026

EEO / Diversity / Inclusion

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

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.