Case Manager, Registered Nurse

CVS Health

Case Manager overseeing patient care and health needs for dual eligible populations in Cook County, Illinois. Collaborating with members, providers, and community organizations to ensure quality outcomes.

Posted 7/2/2026full-timeElmhurst • Illinois • 🇺🇸 United StatesMid-LevelSenior💰 $66,575 - $142,576 per yearWebsite

About the role

Key responsibilities & impact

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.
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.

Requirements

What you’ll need

Candidate must reside within Cook County, Illinois (IL), or be willing and able to travel to Cook County, Illinois (IL)
Candidate must possess reliable transportation and be willing and able to travel up to 50% of the time in Cook County, IL (Mileage is reimbursed per our company expense reimbursement policy)
Candidate must have active and unrestricted Registered Nurse (RN) in Illinois
3+ years clinical practical experience as a Registered Nurse (RN)
2+ years’ experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)
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
Ability to work independently
Certified Case Manager (Preferred)
2+ years case management, discharge planning and/or home health care coordination experience (Preferred)

Benefits

Comp & perks

medical coverage
dental coverage
vision coverage
paid time off
retirement savings options
wellness programs

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Case Management ProcessesAssessment and EvaluationCare CoordinationCondition ManagementDocumentation Preparation

Soft Skills

Analytical SkillsProblem-Solving SkillsEffective CommunicationOrganizational SkillsInterpersonal Skills

Certifications

Registered Nurse (RN)Certified Case Manager (Preferred)