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

$66,575 - $142,576 / year

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.

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

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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Illinois Masonic Medical Center: • Effective 01/01/2012: - New Grads: Bachelor of Science in Nursing (BSN) required - Experienced RNs: Bachelor of Science in Nursing (BSN) required. - Experienced RNs: Invasive Cardiology (Cath/EP) and Operating Room (OR) - ADN may be acceptable with greater than 3 years of experience in specific specialties with agreement on hire to enroll and complete BSN completion program within 3 years of hire. • Certification in your area of specialty once meeting eligibility requirements. - If employed prior to January 1, 2012 and have shown demonstrated attempts but failed to become certified, the associate will be grandfathered. Lutheran General Hospital: • Effective 06/01/2012: ADN acceptable with agreement to enroll in BSN completion program in two years to be completed in five years. Sherman Hospital: • Effective 01/01/2015: ADN acceptable with agreement to enroll in BSN completion program and to be completed in four years. South Suburban Hospital: • ADN acceptable with agreement to enroll in a BSN completion program within two years of hire date and to be completed within five years. Trinity Hospital: • ADN acceptable with agreement to enroll in a BSN completion program within two years of hire date and to be completed within five years. Certification Addendum Associates will maintain annual educational requirements for hospital based certifications (e.g. DNV, CARF or others) Mother Baby: • Completes basic AWHONN FHMPP 2 day course • Completes annual FHR competency • Completes and maintains NRP certification as assigned Emergency Room: • Completes and maintains ECRN certification, if base station. • Completes and maintains ACLS & PALS certification after 1 year experience. • Completes and maintains TNS/TNCC & ECRN certification after 2 years experience ICU/CCU: • Successfully completes ECG course and annual exam • Completes and maintains ACLS certification NICU • Completes and maintains NRP certification within 6 months of hire Mental Health: • No additional requirements M/S Tele: • Completes ECG course and annual exam • Completes and maintains ACLS certification Neuro: • Completes and maintains ACLS certification Oncology: • Completes radiation therapy safety competency. • Completes central line competency including declogging of central lines. • Completes chemotherapy provider course and maintains renewal every 2 years Rehabilitation: • No additional requirements Surgery/OR: • Demonstrates the ability to both scrub and circulate in most cases Interventional Cardiology: • Complies with established radiation safety standards • Completes and maintains ACLS certification Pediatrics: • Completes and maintains ACLS certification within 6 months of hire PICU: • Complete and maintain PALS certification within 6 months of hire Surgical Heart: • Completes ECG course and annual exam • Completes and maintains ACLS certification Pediatric Surgical Heart: • Completes and maintains PALS certification within 6 months of hire IV/Infusion: • Certified Registered Nurse Infusion (CRNI or Vascular Access Certification (VA-BC) within 2 years of hire This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.