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Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll 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.
nProgram Overview
nHelp 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.
nPosition Summary
nThe Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, The Case Management Coordinator facilitates appropriate healthcare outcomes for members by aiding with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.
nKey Responsibilities
nnnEvaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
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nnIdentifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
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nnCoordinates and implements assigned care plan activities and monitors care plan progress.
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nnEnhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
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nnIdentifies and escalates quality of care issues through established channels.
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nnUtilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
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nnUtilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
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nnProvides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
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nnHelps member actively and knowledgably participate with their provider in healthcare decision-making.
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nnMonitoring, Evaluation and Documentation of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
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n nRemote Work Expectations
nnnCandidates must have a dedicated workspace free of interruptions Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
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nnInteracts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician's office to provide ongoing case management services.
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n nRequired Qualifications
nnnMust reside in the state of Illinois
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nnMust possess reliable transportation and be willing and able to travel 50-75% of the time in and around Winnebago, Boone and McHenry counties, IL. Mileage is reimbursed per our company expense reimbursement policy
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nnMust have computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
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nnEffective communication, telephonic and organization skills
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nnExcellent analytical and problem-solving skills
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nnAbility to work independently
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nnAbility to effectively participate in a multi-disciplinary team including internal and external participants.
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nn2 years' experience in behavioral health, social services or appropriate related field equivalent to program focus
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n nPreferred Qualifications
nnnCase management and discharge planning experience
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nnManaged Care experience
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nnBilingual
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n nEducation
nBachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling).
nAnticipated Weekly Hours
n40
nTime Type
nFull time
nPay Range
nThe typical pay range for this role is:
n$21.10 - $44.99
nThis 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.
nOur 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.
nGreat benefits for great people
nWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
nThis 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.
nAdditional details about available benefits are provided during the application process and on Benefits Moments ( .
nWe anticipate the application window for this opening will close on: 10/02/2026
nQualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
nCVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.
Worksite address
rockford, IL, 61103, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.