Case Manager RN (Illinois)

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

This is a full-time telework position with up to 10% travel required. Hours for this position are Monday-Friday 8:00a-5:00p in time zone of residence. A Brief Overview Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.

Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings. Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient. Applies in-depth knowledge of case management and nursing practices to organize patient files in an orderly manner for easy retrieval. Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans. Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care. Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions. Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators. Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home. Develops resource management to help case managers optimize healthcare with community resources.