Case Management Coordinator - Field (Will County)

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

Job summary

CVS Health is seeking a Case Management Coordinator to support members enrolled in Medicare and Medicaid, coordinating care plans and benefits across multiple programs. The role emphasizes evaluation of needs, access to services, and collaboration with clinicians and community partners.

The position requires residency in Will County, IL, and travel 50-75% within Will County and surrounding areas. A bachelor’s or non-licensed master’s in behavioral health or human services is needed, with 2+

Qualifications

• 2+ years experience in behavioral health, social services or related field.
• 2+ years of electronic documentation experience and Microsoft Office applications.

Responsibilities

• Assess member needs and eligibility to inform case resolution.
• Coordinate and implement care plan activities for members.
• Identify high risk factors and refer to clinical case management when needed.
• Monitor care plan progress and ensure regulatory and quality standards are met.
• Engage with members and providers to support informed healthcare decisions.

Skills

Will County residency

Travel 50-75%

Behavioral health experience

Electronic documentation

Microsoft Office

Education

Bachelor's degree or master in behavioral health/human services

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.

Program Overview: Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

Position Summary/Mission: The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.

Fundamental Components

• Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of 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.
• Engages with colleagues in ongoing team meetings and offers peer mentoring/training.
• Helps member actively and knowledgably 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.

Remote Work Expectations

This is a remote-hybrid role; candidates must have a dedicated workspace free of interruptions Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

• Candidate must reside in Will County, Illinois Must be willing and able to travel 50-75% of the time in Will county and surrounding areas. (Reliable transportation required + Mileage is reimbursed per our company expense reimbursement policy)
• 2+ years experience in behavioral health, social services or appropriate related field equivalent to program focus
• 2+ years of experience of electronic documentation experience and Microsoft Office applications

Preferred

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

Education

• Bachelor's degree or non-licensed master level clinician required with either degree being in behavioral health or human services (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 pays range listed above.

Benefits

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: 11/13/2026

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

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.