Case Manager RN (Illinois)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

This is a full-time telework position with up to 10% travel required.

Hours for this position are Monday-Friday 8:00a-5:00p in time zone of residence.

A Brief Overview
Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.

What you will do

• Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings.

• Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient.

• Applies in-depth knowledge of case management and nursing practices to organize patient files in an orderly manner for easy retrieval.

• Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans.

• Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care.

• Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions.

• Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators.

• Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home.

• Develops resource management to help case managers optimize healthcare with community resources.

Required Qualifications

• Must have active and unrestricted RN licensure in the state of IL

• 3+ years of clinical work experience with the adult population

• 1+ year(s) of Case Management experience

• Must be willing and able to travel up to 10% of the time. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

• Compact RN licensure

• Certified Case Manager

• Telephonic Nursing experience

• Home Health experience

• Customer Service experience

• Cold calling experience

• Experience with Medicare population

• Additional national professional certification (CRC, CDMS, CRRN, COHN) is preferred, but not required

• Remote working experience

Education

• Associate's Degree minimum required, Bachelor’s degree preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $142,576.00

This 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. 
 

Our 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.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purc