Case Manager Registered Nurse - Field - Winnebago County, IL - New hire bonus available!

divh2Case Manager/h2pWere building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, youll 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./ppHelp 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./ppFacilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies./ppOur Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individuals and familys comprehensive health needs through communication and available resources to promote quality, cost effective outcomes./ppFundamental Components Physical Requirements/pulliActs as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate./liliImplements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care./liliInteracts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physicians office to provide ongoing case management services./liliAssesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/clients appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate./liliCommunicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person./liliPrepares all required documentation of case work activities as appropriate./liliInteracts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes./liliMay make outreach to treating physician or specialists concerning course of care and treatment as appropriate./liliProvides educational and prevention information for best medical outcomes./liliApplies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources./liliConducts an evaluation of members/clients needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data./liliUtilizes case management processes in compliance with regulatory and company policies and procedures./liliFacilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work./liliDevelops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a members/clients overall wellness through integration./liliMonitors member/client progress toward desired outcomes through assessment and evaluation./li/ulpRequired Qualifications/pulliMinimum 3-5 years clinical practical experience preference required/liliConfidence working at home/independent thinker, using tools to collaborate and connect with teams virtually/liliAbility to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise/liliExcellent analytical and problem-solving skills/liliEffective communications, organizational, and interpersonal skills/liliAbility to work independently/liliProficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications./liliEfficient and Effective computer skills including navigating multiple systems and keyboarding/liliMust live in Winnebago County or willing to drive to area/li/ulpPreferred Qualifications/pulliMinimum 2-3 years CM, discharge planning and/or home health care coordination experience/liliCertified Case Manager is preferred./li/ulpEducation/pulliAssociates Degree/li/ulpLicensure/pulliRegistered Nurse with active state license in good standing within the region where job duties are performed is required./li/ulpAnticipated Weekly Hours/pp40/ppTime Type/ppFull time/ppPay Range/ppThe typical pay range for this role is:/pp$66,575.00 - $142,576.00/ppThis 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./ppOur 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./ppGreat benefits for great people/ppWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families./ppThis 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./ppAdditional details about available benefits are provided during the application process and on Benefits Moments./ppWe anticipate the application window for this opening will close on: 07/01/2026/ppQualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws./p/div