Case Manager Registered Nurse - Field in Northern Suburbs or Chicago Illinios

4004 Aetna Medicaid Administrators; Illinois; On-site; USD 67,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Nurse Case Manager to coordinate all case management activities for members, evaluating medical needs and facilitating overall wellness. This field-based role requires 50-75% travel to meet members face to face in the Northern suburbs of Chicago, IL. The candidate must reside in the Northern suburbs area and hold an active IL RN license.

Schedule is Monday–Friday, 8:00am–5:00pm CST. The role involves telephonic and in-person assessments, planning, implementing, and

Qualifications

• 3 years of clinical practice experience required.
• 1 year experience using MS Office applications.

Responsibilities

• Coordinates all case management activities with members to evaluate medical needs and to facilitate overall wellness.
• Develops strategy to address issues to outcomes and opportunities to enhance member's wellness through integration.
• Instructs programs and procedures in compliance with network management and clinical coverage policies.
• Telephonic and face-to-face assessments, planning, implementing and coordinating all case management activities with members.

Skills

MS Office

Education

Associate's degree with RN licensure

BSN preferred

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

Coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members. Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration. Instructs programs and procedures in compliance with network management and clinical coverage policies. This is a field-based position with expected travel of 50-75% to meet with members face to face in Northern suburbs of Chicago. Must reside in Northern suburbs of Chicago or surrounding areas (i.e. Shorewood, Wheaton, Elmhurst, West Chicago, Carol Stream, Addison, Hanover Park, Bartlett, Batavia, and St. Charles IL.). Schedule is Monday-Friday, standard business hours, 8:00am-5:00pm CST. Nurse Case Manager is responsible for telephonic and 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.

Responsibilities

• 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

• Minimum 3 years of clinical practice experience required.
• Minimum 1 year experience using MS office suite applications.
• Current Active unrestricted RN licensure in the state of IL required.
• Willing and able to travel 50-75% of their time to meet members face to face in Northside suburbs of Chicago.
• Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications

• Case Management in an integrated model preferred.
• Experience working with adults with Behavioral Health needs preferred.

Education

• Associate's degree with RN licensure required.
• Bachelor's of Science & Nursing preferred.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $66,575.00 - $142,576.00 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.

Benefits

• medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources

Additional details about available benefits are provided during the application process and on Benefits Moments.

Application Window

We anticipate the application window for this opening will close on: 11/30/2026

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.