Remote RN Case Manager for Medicare/Medicaid

CVS Health

Lincoln (IL)

On-site

USD 67,000 - 143,000

Full time

6 days ago

Be an early applicant

Application generator

Turn this role into an interview — a resume and cover letter built around what this employer wants.

Get past ATS filters

Benefits offered by this job

Medical, Dental & Vision coverage

Paid Time Off

Retirement Savings plan

Job summary

CVS Health is seeking an RN to elevate patient care in Illinois. You will support members enrolled in Medicare/Medicaid, coordinate care with providers and community partners, and address complex medical and social needs. Remote-friendly, travel within the state may be required.

You will collaborate with care teams, educate members on disease management and benefits, and document activities in line with regulatory standards.

Qualifications

Active and unrestricted Registered Nurse license in IL.
3–5 years of clinical nursing experience.
2–3 years in case management, discharge planning, care coordination, or home health.
Strong clinical assessment, critical thinking and problem-solving.
Excellent communication, organizational and interpersonal skills.
Ability to work independently and remotely.
Willingness to travel within the assigned geographic area.
Proficiency with Microsoft Office and care management systems.

Responsibilities

Serve as a liaison among members, families, providers, employers, health plans and other stakeholders.
Coordinate and manage care activities for members with complex health conditions.
Conduct comprehensive assessments of medical, functional, psychosocial and environmental needs.
Develop, implement and monitor individualized care plans to improve health outcomes.
Facilitate access to healthcare services, home health and community resources.
Engage with members via telephonic and in-person visits.
Collaborate with interdisciplinary care teams to ensure coordinated care.
Educate members on disease management, benefits and resources.
Conduct outreach to treating physicians and providers for care planning.
Monitor progress and adjust care plans as needed.
Maintain accurate documentation per guidelines and regulatory requirements.
Ensure compliance with laws, policies and case management standards.
Promote optimal health outcomes and quality of life through proactive intervention.