Case Manager Registered Nurse - Field - Jefferson County IL

Case Manager Registered Nurse – Field – Jefferson County, IL or Surrounding Areas

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose‑driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.

We do it all with heart, each and every day.

This is a field‑based position with 50–75% travel to meet members face‑to‑face in Jefferson County and surrounding areas. Monday–Friday 8 am–5 pm. The role holds a full caseload to manage waiver members and requires quarterly in‑person visits. It is critical to meet contractual requirements and to facilitate appropriate health‑care outcomes for waiver/LTSS members by providing care coordination, support and education.

• Conduct comprehensive evaluation of referred members’ needs and eligibility using care‑management tools and data review; recommend an approach to case resolution.
• Identify high‑risk factors and service needs that may impact member outcomes and refer to clinical case management or crisis intervention as appropriate.
• Coordinate and implement assigned care‑plan activities and monitor care‑plan progress.
• Consult with case managers, supervisors, medical directors and other health programs to overcome barriers to meeting goals; present cases at conferences for multidisciplinary review.
• Escalate quality‑of‑care issues through established channels and secure appropriate options and services to meet members’ benefits and healthcare needs.
• Use influencing/motivational interviewing skills to promote member engagement and lifestyle/behavior changes.
• Coach and empower members to make independent medical and healthy‑lifestyle choices; facilitate participation in healthcare decision‑making.
• Apply case‑management and quality‑management processes in compliance with regulations, accreditation guidelines and company policies.

• 2+ years of clinical experience.
• Active Illinois Registered Nursing license in good standing.
• Resident of Jefferson County or surrounding areas.
• Reliable transportation and willingness to travel 50–75% of the time; mileage reimbursed.

• Case‑management and discharge‑planning experience.
• Managed‑care experience.
• Microsoft Office proficiency.

• Associate’s Degree in Nursing required.
• Bachelor’s of Science in Nursing preferred.

Anticipated Weekly

Hours:

40

Time Type: Full time

Pay Range: $66,575.00 – $ (base hourly or base annual full‑time salary). The actual base salary will depend on experience, education, geography and other factors.

• Affordable medical plan options, 401(k) plan with company match and employee stock purchase plan.
• No‑cost programs: wellness screenings, tobacco cessation, weight management, counseling and financial coaching.
• Benefit solutions for diverse needs: paid time off, flexible schedules, family leave, dependent‑care resources, assistant programs, tuition assistance, retiree medical access, and more (subject to eligibility).

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