RN Full-time
CVS Health

Clinical Care Manager - Registered Nurse - Field - 60610, 60642, 60622, 60647

CVS Health IL, US
$66,575 - $142,576 / year
Apply Now

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.

Position Summary

Help 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.

 

Facilitate 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.

Our 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.

Our 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.

 

  • Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
  • Implements 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.
  • Interacts 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.
  • Assesses 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.
  • Communicates with member/client and other stakeholders as appropriate (e.g., medicalproviders, attorneys, employers and insurance carriers) telephonically or in person.
  • Prepares all required documentation of case work activities as appropriate.
  • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
  • May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
  • Provides educational and prevention information for best medical outcomes.
  • Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
  • Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
  • Utilizes case management processes in compliance with regulatory and company policies and procedures.
  • Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
  • Develops 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.
  • Monitors member/client progress toward desired outcomes through assessment and evaluation.

 

Required Qualifications

  • Candidate must have active and unrestricted Registered Nurse (RN) License in Illinois
  • Ability to travel within a designated geographic area up to 50-75% of the time in 60610, 60642, 60622, 60647 and surrounding zip codes for in-person case management activities as directed by leadership and/or as business needs arise
  • 3-5 years clinical practical experience
  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
  • Efficient and effective computer skills including navigating multiple systems and keyboarding

Preferred Qualifications

  • 2-3 years case management, discharge planning and/or home health care coordination experience

Education

  • Associate’s Degree in Nursing (REQUIRED)
  • Bachelor’s Degree in Nursing (PREFERRED)

License

  • Active and unrestricted Illinois Registered Nurse (RN) License

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,575.00 - $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 purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/10/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member’s capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient’s medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain. Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient’s response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient’s age Receives physician’s orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient’s status to identify each patient’s age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients’ condition Answers telephone, paging system, patients’ call lights, anticipates patients’ needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient’s needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/Expectations Knowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0% Must read, write and speak fluent English Must have good and regular attendance Performs other related duties as assigned Pay Range: $40.00 - $60.00/Hour ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Graduation from an accredited Bachelor of Science in Nursing Associate Degree in Nursing or Nursing Diploma program Licenses/Certification Current state licensure as Registered Nurse BCLS certification required ACLS certifications preferred Experience Minimum six months’ Medical/Surgical experience in an acute care setting preferred