Case Manager Registered Nurse Field Chicago 60616, 60608

Were building a world of health around every individual shaping a more connected convenient and compassionate health experience. At CVS Health youll be surrounded by passionate colleagues who care deeply innovate with purpose hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person one family and one community at a time.

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.

• 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 andtreatment 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 policiesand 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 members/clients overall wellness through integration.
• Monitors member/client progress toward desired outcomes through assessment andevaluation.

Required Qualifications

• 3 years clinical practical experience preference
• Candidate must have the ability to travel up to 50% within Chicago Zip Codes:
• Candidate must have active and unrestricted Registered Nurse (RN) License in Illinois (IL)
• Candidate must have a valid and active drivers license and possess reliable transportation

Preferred Qualifications

• 2 years case management discharge planning and/or home health care coordination experience
• Confidence working at home/independent thinker using tools to collaborate and connect with teams virtually
• Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
• Excellent analytical and problem-solving skills
• Effective communications organizational and interpersonal skills
• Ability to work independently
• Proficiency with standard corporate software applications including MS Word ExcelOutlook and PowerPoint as well as some special proprietary applications
• Efficient and effective computer skills including navigating multiple systems and keyboarding
• Live near zip codes
• Certified Case Manager
• Bilingual in Cantonese/English

Education

• Associates Degree or Nursing Diploma (REQUIRED)
• Bachelors Degree (PREFERRED)

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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