Hybrid Case Manager – Healthcare, Travel Required

CVS Health; Illinois; Remote; USD 29,000 - 62,000; Full time

Job summary

CVS Health is seeking a healthcare management professional to join our remote team in Illinois with 50-75% travel to meet members in person. You will oversee medical necessity decisions, educate customers, and drive program efficiency while navigating regulatory requirements.

Bachelor’s or higher in behavioral health, with 2+ years in case management and strong Excel skills, is preferred. This full-time role offers competitive pay, benefits, and mileage reimbursement, with travel focused in

Qualifications

• Minimum 2 years of experience in behavioral health, social services or human services field.
• Minimum 2 years of case management experience.
• Willing and able to travel up to 50-75% with own vehicle.
• Valid Illinois Driver’s License.

Responsibilities

• Determines medical necessity/ appropriateness
• Facilitates optimal outcomes
• Identifies and follow through with continuous quality/ compliance opportunities
• May also include identification of aberrance's and initiation of corrective action
• Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
• Optimize total costs Implementation and evaluation of policy based on usage and program directives
• Educate/empower colleagues at all levels to enable decision making at most appropriate level

Skills

Behavioral health

Case management

Education

Bachelor's degree or non-licensed master level clinician

Tools

Excel

Job description

CVS Health is seeking a healthcare management professional to join our remote team in Illinois with 50-75% travel to meet members in person. You will oversee medical necessity decisions, educate customers, and drive program efficiency while navigating regulatory requirements.

Bachelor’s or higher in behavioral health, with 2+ years in case management and strong Excel skills, is preferred. This full-time role offers competitive pay, benefits, and mileage reimbursement, with travel focused in