Case Manager, Registered Nurse – Illinois License

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Create proactive care plans to tackle identified challenges and enhance both short- and long-term outcomes as well as overall wellness.

• Assess member needs and benefits through clinical tools and comprehensive information/data analysis.

• Utilize clinical judgment to mitigate risk factors and barriers while addressing complex health and social determinants.

• Perform holistic assessments using claims and various resources, considering co-morbidities and multiple diagnoses that impact functionality.

• Determine the necessity for referrals to clinical resources and interdisciplinary team members.

• Work collaboratively with supervisors, providers, community organizations, and other stakeholders to navigate obstacles and achieve objectives.

• Present cases during interdisciplinary case conferences.

• Implement case management processes in accordance with regulatory standards and company policies and procedures.

• Employ motivational interviewing techniques to enhance member engagement and evaluate health status and needs.

• Engage with members and clients via telephone or in person.

• Provide continuous case management services in members' homes, workplaces, or physician offices as required.

• Travel within a specified geographic area for in-person case management tasks based on leadership direction and business requirements.

⛳️ Requirements

• Active Registered Nurse license in good standing in Illinois.

• A minimum of 3-5 years of clinical practical experience.

• At least 2-3 years of experience in case management, discharge planning, and/or home health care coordination is preferred.

• Strong analytical and problem-solving abilities.

• Excellent communication, organizational, and interpersonal skills.

• Capability to work independently from home.

• Proficiency in MS Word, Excel, Outlook, PowerPoint, and proprietary software.

• Competent computer skills, including the ability to navigate multiple systems and proficient keyboarding.

• Reliable transportation is essential.

• Willingness and ability to travel up to 40% of the time.

• An associate degree is required; a bachelor's degree is preferred.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload.

• WiFi and satellite internet connections are not acceptable.

• A quiet, secure, private, designated home workspace that meets CVS Health and HIPAA guidelines.

• Must reside and work within the state and city of current residence.

• Must furnish own workspace furniture.

• Ability to set up and use multiple monitors and navigate various applications effectively.

• Proficient in communicating through email, calendar invites, Teams messaging, and virtual meetings.

• Familiarity with Microsoft Office 365 applications or similar Google Workspace applications.

• Capability to log into secure systems such as VPN and EHR portals, manage strong passwords, and recognize suspicious emails or links.

• Ability to independently resolve common technical issues and contact IT for unresolved problems.

• Willingness to learn new workplace skills.

• Certified Case Manager and additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources for supporting physical, emotional, and financial well-being.

• Mileage reimbursement in accordance with the company expense reimbursement policy.

• Company-provided equipment (keyboard, monitor, computer, headset, etc.).