Case Manager, Registered Nurse

Job not on LinkedIn

🔥 27 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Facilitate assessment, planning, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs • Act as liaison among members/clients/families, employers, providers, insurance companies, attorneys, and healthcare personnel • Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care • Arrange consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members/clients telephonically or in person, including at homes, worksites, or physicians’ offices when required • Assess and analyze medical and/or vocational status and develop individualized plans of care • Facilitate condition management, wellness, medical outcomes, eligibility determinations, and return to work or optimal functioning • Communicate with members and stakeholders regarding treatment and course of care • Prepare required case work documentation • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply rehabilitation-services laws, regulations, and insurance-carrier instructions • Evaluate member needs and benefit-plan eligibility using clinical tools and data • Monitor member progress toward desired outcomes through assessment and evaluation • Develop proactive action plans to improve short- and long-term outcomes and overall wellness

🎯 Requirements

• Active and unrestricted Illinois (IL) Registered Nurse (RN) License • Associate's Degree or Nursing Diploma (REQUIRED) • 2+ years case management, discharge planning and/or home health care coordination experience • 3+ years clinical practical experience preferred, including diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac experience with Medicare members • Excellent analytical and problem-solving skills • Ability to occasionally travel within a designated geographic area for in-person case management activities • Effective communication, organizational, and interpersonal skills • Ability to work independently • Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, Microsoft Office 365, Teams, and/or similar applications • Efficient computer skills, including navigating multiple systems and keyboarding • Willingness and ability to obtain multi-state Registered Nurse licenses if needed • Certified Case Manager preferred • National professional certification preferred: CRC, CDMS, CRRN, COHN, or CCM • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private, and HIPAA-compliant home work location • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to use digital communication tools such as email, calendar invites, Teams messaging, and virtual meetings • Ability to access secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Must work within the state and city where currently living

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Company will provide required multi-state RN licenses if needed • Comprehensive benefits package for eligible full-time colleagues