Case Manager Registered Nurse - Field - reside in DuPage County Illinois

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Join Aetna's Illinois care management team supporting the D‑SNP FIDE (Fully Integrated Dual Eligible Special Needs Plan) population. As a Case Manager - RN Field, you will deliver person‑centered, whole‑person case management for dual‑eligible members with complex medical, behavioral, functional, and social determinant needs. This role integrates clinical assessment, care planning, coordination, advocacy, transitions‑of‑care support, and evaluation to drive high‑quality, cost‑effective outcomes.

You will collaborate closely with members, caregivers, providers, and community partners to support the full continuum of integrated medical and behavioral health care, conduct telephonic and in‑person field visits throughout DuPage County and surrounding areas, and address barriers to care, including social determinants of health (SDOH). Responsibilities include completing comprehensive clinical assessments, developing and updating individualized care plans, providing crisis intervention/follow‑up, applying clinical criteria and guidelines, escalating quality‑of‑care concerns, presenting cases in multidisciplinary rounds, documenting and evaluating outcomes in compliance with regulatory and organizational standards, and actively monitoring member progress toward health and wellness goals.

• Must reside in DuPage County, Illinois, and be able to travel throughout DuPage and surrounding counties for in‑person case management activities.
• Active, unrestricted Registered Nurse (RN) license in the state of Illinois.
• 3-5 years of direct clinical practice experience (e.g., hospital, ambulatory, outpatient, home health, or community setting).
• 2-3 years of case management, discharge planning, home health coordination, or equivalent experience.
• Ability to independently manage a remote/home‑based workload while using virtual collaboration tools.
• Strong analytical and problem‑solving skills with the ability to apply clinical judgment in complex cases.
• Effective written and verbal communication skills and strong organizational and interpersonal abilities.
• Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, Teams, and the ability to learn new systems and applications quickly.
• High level of computer efficiency, including navigating multiple systems and accurate keyboarding.
• Ability to conduct in‑person case management activities as directed by leadership and based on business need.

• Prior case management experience working with D‑SNP, FIDE‑SNP, or other dual‑eligible populations.
• Experience in managed care, utilization review, or transitions‑of‑care coordination.
• Experience with crisis assessment, intervention, and follow‑up.
• Prior field‑based or home‑visiting case management experience.
• Knowledge of Medicaid, Medicare, and community‑based resources in Illinois.
• CCM (Certified Case Manager) certification preferred.

• Registered Nurse (RN) Licensure.
• Associate’s Degree in Nursing required.
• Bachelor of Science in Nursing strongly preferred.
• Case Management certification (e.g., CCM) preferred.

40

Full time

The typical pay range for this role is:
$66,575.00 - $
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.

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