This job is closed
Applications are no longer available for this announcement. Explore current related opportunities below.
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.
nPosition Summary
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.
nFacilitate 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.
nOur Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
nFundamental Components & Physical Requirements
nnnActs as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
n
nnImplements 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.
n
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.
n
nnAssesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s 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.
n
nnCommunicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
n
nnPrepares all required documentation of case work activities as appropriate.
n
nnInteracts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
n
nnMay make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
n
nnProvides educational and prevention information for best medical outcomes.
n
nnApplies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
n
nnConducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
n
nnUtilizes case management processes in compliance with regulatory and company policies and procedures.
n
nnFacilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
n
nnDevelops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration.
n
nnMonitors member/client progress toward desired outcomes through assessment and evaluation.
n
n nRequired Qualifications
nnnCandidate must reside in Kane, LaSalle or Surrounding Counties
n
nnCandidate must possess reliable transportation and be willing and able to travel up to 50-75% of the time in Kane, LaSalle and other surrounding Counties (Mileage is reimbursed per our company expense reimbursement policy)
n
nn3+ years clinical practical experience
n
nnConfidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
n
nnExcellent analytical and problem-solving skills
n
nnEffective communication, organizational, and interpersonal skills
n
nnAbility to work independently
n
nnProficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint
n
nnEfficient and effective computer skills including navigating multiple systems and keyboarding
n
n nPreferred Qualifications
nnn2+ years case management, discharge planning and/or home health care coordination experience
n
nnCertified Case Manager
n
n nEducation
nnnAssociate’s Degree in Nursing (REQUIRED)
n
nnBachelor’s Degree in Nursing (PREFERRED)
n
n nLicense
nnActive and unrestricted Registered Nurse (RN) in Illinois
n nTechnical and Logistical Requirements
nnnDevice & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
n
nnCommunication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
n
nnCollaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
n
nnSystems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
n
nnTroubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
n
nnFuture Growth: Openness to learning new skills in the future as the workplace environment evolves
n
n nAnticipated Weekly Hours
n40
nTime Type
nFull time
nPay Range
nThe typical pay range for this role is:
n$66,575.00 - $142,576.00
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: 10/30/2026
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
batavia, IL, 60510, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.