RN Case Manager - Dual-Eligible Care Coordinator

CVS Health; Springfield (IL); Hybrid; USD 67,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Benefits details during process

Job summary

CVS Health in Illinois is seeking a dedicated RN Case Manager to coordinate care for members with complex health and social needs. You will liaise with members, providers and insurers to promote wellness and timely return to work.

This full-time role requires 3+ years of clinical experience, an Illinois RN license, and the ability to travel up to 50% of the time within Kane, LaSalle and surrounding counties. You will work independently using Teams, EHR systems and other tools.

Qualifications

• Active and unrestricted RN license in Illinois.
• 3+ years clinical experience in healthcare.
• Willingness to travel up to 50% across Kane/LaSalle counties.
• Strong analytical, communication and problem-solving skills.
• Ability to work independently with remote collaboration tools.

Responsibilities

• Liaise with members, employers, providers, insurers and healthcare staff.
• Coordinate case management activities for complex cases.
• Interact with members by phone or in person; home/worksite visits as needed.
• Assess medical and vocational status; develop care plans to optimize outcomes.
• Document case work activities and communicate with stakeholders.
• Collaborate with an internal multidisciplinary team to maximize outcomes.
• Provide education and prevention information for better outcomes.
• Ensure compliance with laws, regulations and insurer requirements.
• Evaluate member needs and eligibility for benefits; facilitate actions.
• Facilitate appropriate care coordination and return-to-work goals.

Skills

Analytical skills

Communication

Independent worker

Problem solving

Organization

Education

ASN in Nursing

BSN preferred

Tools

Microsoft Word

Excel

Outlook

PowerPoint

VPN

EHR portal

Job description

CVS Health in Illinois is seeking a dedicated RN Case Manager to coordinate care for members with complex health and social needs. You will liaise with members, providers and insurers to promote wellness and timely return to work.

This full-time role requires 3+ years of clinical experience, an Illinois RN license, and the ability to travel up to 50% of the time within Kane, LaSalle and surrounding counties. You will work independently using Teams, EHR systems and other tools.