Case Management Coordinator - Field - Southern IL

CVS Health

Centralia (IL)

On-site

USD 29,000 - 62,000

Full time

8 days ago

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Job summary

CVS Health in Illinois is seeking a Case Management Coordinator to assess, develop and coordinate care plans for members, with telephonic and face-to-face interactions. The role emphasizes holistic wellness, leveraging clinical tools, and collaboration with Aetna programs to ensure effective care transitions.

Travel 50-75% is required, and a bachelor’s or master’s in behavioral health or human services is preferred.

Qualifications

  • Southern Illinois residency and surrounding counties required.
  • Minimum of 2 years in case management, behavioral health, social services, or related field.
  • Willing and able to travel 50-75% with own vehicle to meet members face to face in surrounding areas.

Responsibilities

  • Assess, plan, implement and coordinate all case management activities telephonically and/or face to face.
  • Assessments consider member needs, benefit plan eligibility and integration with Aetna programs.
  • Consult with supervisor and others to overcome barriers and present cases for multidisciplinary focus.

Skills

Case management experience
Behavioral health experience
Travel readiness
Driver's license

Education

Bachelor's or Master in Behavioral Health or Human Services

Tools

Microsoft Office (Excel)

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 Management Coordinator 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.

  • 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
  • Candidate must reside in southern Illinois and surrounding counties
  • Minimum of 2 years of experience in case management, behavioral health, social services, or related field
  • Willing and able to travel using your own vehicle 50-75% of their time to meet with members face to face in surrounding areas
  • Valid Drivers License, preferably in IL
Preferred Qualifications
  • Long Term Care Experience
  • Case Management or Discharge Planning experience
  • Managed care experience
  • Microsoft Office (Excel) experience
Education:
  • Bachelor's Degree or non-licensed master level clinician required, preferably with a degree either being in behavioral health or human services
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: 11/16/2026

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

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