Case Manager, Registered Nurse – RN Illinois

CVS Health Careers

. Develop proactive courses of action to address member issues and improve short- and long-term outcomes .

Posted 11/10/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical assessment and case management, utilizing a holistic approach to enhance member wellness and address complex health needs. Proficient in navigating healthcare systems and regulatory requirements while maintaining compliance with HIPAA guidelines.

Highest-signal resume keywords

Active Illinois RN Licensure2+ Years Clinical Experience as an RNCase Management ExperienceCertified Case Manager (CCM) CertificationStrong Telephonic Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCase Management ProcessesHolistic ApproachEvaluation of Member NeedsRisk Factor ReductionCo-Morbidity AssessmentBenefit Plan Eligibility ReviewTechnical TroubleshootingMultiple Monitor SetupEHR Portal Navigation

Soft Skills

Communication SkillsMember EngagementCollaborationProblem-SolvingAdaptability

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNSecure Systems AccessClinical Tools

Certifications & Qualifications

Certified Case Manager (CCM)Compact RN Licensure

Industry Keywords

HIPAA ComplianceHealthcareMember WellnessClinical JudgmentMultidisciplinary Case Conferences

About the role

Key responsibilities & impact

Develop proactive courses of action to address member issues and improve short- and long-term outcomes
Identify opportunities to enhance members’ overall wellness through integration
Use clinical tools and information/data review to evaluate member needs and benefit plan eligibility
Facilitate integrative functions and smooth transitions to Aetna programs and plans
Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
Assess co-morbidities and multiple diagnoses affecting functionality
Review prior claims for potential impact on case management and eligibility
Assess members’ work capacity and related restrictions or limitations
Use a holistic approach to determine need for referral to clinical resources
Consult with supervisors and others to overcome barriers and meet goals and objectives
Present cases at multidisciplinary case conferences
Follow case management processes, regulatory requirements, and company policies
Conduct interviews to maximize member engagement and determine health status and needs
Work Monday through Friday during an 8-hour shift, with occasional late-shift rotation until 8:00pm EST
Work remotely from home with no expected travel, weekends, or holiday shifts

Requirements

What you’ll need

Active Illinois RN licensure; candidate does not need to live in Illinois
2+ years of clinical experience as an RN
Associate’s degree in nursing required
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where the employee currently lives
Ability to set up and use multiple monitors and navigate multiple applications
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace tools
Ability to log in to secure systems such as VPN and EHR portals
Ability to maintain strong passwords and recognize suspicious emails or links
Ability to troubleshoot common technical issues and contact IT when needed
Willingness to learn new skills as the workplace evolves
BSN preferred
1+ years of case management experience preferred
Compact RN licensure or willingness and ability to obtain multiple state RN licensure after hire preferred
Certified Case Manager (CCM) certification preferred
Strong telephonic communication skills preferred

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Company-provided equipment (keyboard, monitor, computer, headset, etc.)
Expenses paid by company for obtaining multiple state RN licensure after hire