Case Manager in United States

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Location Bureau County or surrounding area. Program Overview 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 dually eligible members to change lives in new markets across the country. Position Summary/Mission Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Fundamental Components & Physical Requirements Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Uses clinical to

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Registered Nurse Case Manager – Field in Suffolk, Brooklyn, Kings and Queens and surrounding counties, NY Position Summary: This position is a field‑based Registered Nurse (RN) role responsible for conducting member assessments for new NY Better Health enrollees, annual reassessments, semiannual reviews, and change‑in‑condition visits. The nurse will complete 2–3 home visits per day, with all documentation expected within 24 hours of each assessment. The role requires extensive travel (up to 75%) across assigned Suffolk and Surrounding Counties, NY and close collaboration with the Scheduler/CM Assistant who coordinates Work hours are Monday–Friday, 8:30 a.m.–5:00 p.m. EST. Key Responsibilities: Initial Assessments — Conduct member assessments for new NY Better Health applicants. Reassessments — Perform annual, semiannual, and change‑in‑condition assessments per regulatory and plan requirements. Clinical Documentation — Submit complete, accurate documentation within 24 hours of each visit. Care Coordination — Communicate findings to interdisciplinary teams to support care planning. Travel & Scheduling — Maintain punctuality and reliability for 2–3 daily home visits coordinated by the scheduling team. Independent Work — Operate effectively in a remote/telephonic environment while collaboratin

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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: The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the member’s improved health. The Case Manager 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 member’s overall wellness. Services strategies policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers Region. Qualified candidates must reside in one of the counties within Two Rivers (Union, Webster, Henderson, Daviess, Hancock, McLean, Ohio, Butler, Edmonson, Hart, Warren, Logan, Simpson, Allen, Monroe, Metcalfe, Barren). Evaluation of Members: Through the use of clinical assessment tools and evaluating information/data review, conducts a comprehensi

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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 Location: Work From Home – Flexible, Travel Required: 25 – 50% (Wayne and Macomb Counties) Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST No evenings, weekends, or major holidays 4 day/10-hour schedule available after training ​ Our Mission The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. This role ensures members receive appropriate waiver and community-based services to promote safety, independence, and improved health outcomes while maintaining regulatory compliance. This position includes in-home visits to complete functional assessments, evaluate eligibility for waiver services, and develop person-centered service plans. 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

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Job Summary The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies. Key Responsibilities 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs. Provides evidence-based disease manag

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Requisition Job Description Program Overview: 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. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources Required Qualifications • Must reside in the state of Illinois •Must possess reliable transportation and be willing and able to travel up to 50-75% of the tim

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Registered Nurse Case Manager – Field (Monmouth & Surrounding Counties, NJ) New Hire Bonus Available Make a Meaningful Impact in Your Community We’re looking for a compassionate and experienced Registered Nurse who enjoys working both independently and out in the community. In this role, you’ll help coordinate care for members with complex needs, supporting them in living safely and comfortably at home. This is primarily a field-based role with flexibility to work from home when not in the field, offering a great balance of independence and purpose-driven work. Travel & Work Schedule: Field-based role - Must possess reliable transportation and be willing and able to travel up to 75% of the time in your county of residence as well as the surrounding area’s. Mileage is reimbursed by our company expense reimbursement policy Most travel is daytime, local driving (generally within 60 minutes of your home base) No overnight travel required Travel is planned and scheduled in advance, with flexibility to help manage your day Standard schedule: Monday–Friday, 8:00 AM – 5:00 PM (no weekends or holidays required) If you enjoy getting out into the community and building relationships face-to-face, this role offers a dynamic and rewarding workday. What You’ll Do:</

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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: Registered Nurse Case Manager – Field in Danville & Martinsville, VA Schedule: Monday–Friday, 8:00 AM – 5:00 PM EST We’re looking for a compassionate and motivated Registered Nurse Case Manager to join our team, supporting members in the Danville & Martinsville, Virginia area. This is a field-based role that blends in-person visits with telephonic outreach to deliver coordinated, patient-centered care. What You’ll Do: As a Nurse Case Manager, you will play a critical role in improving the health and well-being of members by coordinating care, removing barriers, and supporting better outcomes. In this role, you will: Conduct comprehensive assessments (telephonic and face-to-face) to evaluate members’ medical, behavioral, and social needs Develop and implement personalized care plans that promote both short- and long-term wellness Coordinate care across providers, programs, and services to ensure a seamless experience for members Use clinical expertise and data insights to identify risks, gaps in care, and opportunities for intervention Support members with complex or multiple conditions by applying a holistic

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. Case Manager (RN) – Field Location: Mesquite, Balch Springs, Forney, Talty, Seagoville, Hutchins, Lancaster, Ferris, Red Oak, Cockrell Hill, Cedar Hill, Wilmer, West Dallas, Highland Park and South Dallas (Remote with local travel) Travel: Up to, 75% within territory Position Summary Nurse Case Manager (RN) for a work-from-home role that requires frequent local travel for in-home member visits and occasional visits to nursing facilities within the Dallas & Surrounding Areas in Texas In this role, you will deliver high-quality case management services through a combination of telephonic and face-to-face engagement, helping members navigate their healthcare needs and achieve improved health outcomes. Key Responsibilities Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines Coordinate and monitor ongoing care plan activities, adjusting as needed to improve outcomes Collaborate in multidisciplinary care reviews to optimize member health results Identify and escalate quality of care concerns through appropriate channels Engage members using motivational interviewing and coaching techniques to encourage healthy lifes

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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 The High-Fidelity Wraparound (HFW) Case Manager (CM) is a person who safeguards that the principles of the wraparound process are delivered with the highest possible fidelity to the model. Hours for this position are Monday - Friday 8:00am - 5:00pm. This position is located in the Lakes Region, including the counties of: Ballard, Caldwell, Calloway, Carlisle, Christian, Crittenden, Fulton, Graves, Hickman, Hopkins, Livingston, Lyon, Marshall, McCracken, Muhlenberg, Todd and Trigg. Position requires at least 50% travel within region and, possibly at times, outside region, if necessary. The HFW CM offers consultation and education to all providers regarding the values of the wraparound process, monitors progress toward goals, and assures that all necessary data for evaluation are gathered and entered. The HFW CM helps the youth and family develop and integrate their natural support system and to manage their own services, supports, and plan. Duties: The HFW CM is responsible for completing a comprehensive strengths-based assessment/screening (Health Risk Questionnaire, Pediatric assessment, and any other applicable) of the individual Working in full partnership with the High-Fidelity team members to develop and i

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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. RN Nurse Case Manager – Field- Location: Northern Virginia: Fairfax, Sterling, Reston, Ashburn and surrounding Virginia Areas Schedule: Mon-Fri 8:00-5:00 PM EST Travel: Up to75% Position Overview: We’re looking for a compassionate and motivated Registered Nurse Case Manager to join our team, supporting members in the Fairfax, Sterling, Reston, Ashburn and surrounding areas of Virginia. This is a field-based role that blends in-person visits with telephonic outreach to deliver coordinated, patient-centered care. What You’ll Do: As a Nurse Case Manager, you will play a critical role in improving the health and well-being of members by coordinating care, removing barriers, and supporting better outcomes. In this role, you will: Conduct comprehensive assessments (telephonic and face-to-face) to evaluate members’ medical, behavioral, and social needs Develop and implement personalized care plans that promote both short- and long-term wellness Coordinate care across providers, programs, and services to ensure a seamless experience for members Use clinical expertise and data insights to identify risks, gaps in care, and opportunities for intervention Support members with complex or multiple conditions by applying a holistic, whole-person app

The Senior RMA Customer Experience Manager will work with the key customer account team leads to ensure customers have timely case updates. The position has to decide on fulfilment priority based on Service Level Agreements and track regional buffer stock. The manager needs to work with account leads to track the impact of open RMAs on customer datacenter capacity, so as to make allocation decisions. What you’ll be doing: Customer Satisfaction: Manage RMA cases and lead all aspects of replacement part fulfillment to clear the open RMA backlog per Service Level Agreements. Work with account teams to prioritize backlog in case of supply constraints. Case Management: Attend customers meeting, provide accurate and up-to-date information on case status, track of customer feedback and develop strategies to improve the overall customer experience. Metrics and Improvement: Generate case management metrics and analyze data to identify process improvement opportunities. Publish weekly status updates on open RMAs – supply commits, ready for pickup, shortage alerts. Collaboration: Work closely with quality and manufacturing teams to effectively communicate RMA updates and statuses to customer account teams. Facilitate seamless information flow between teams to provide exceptional customer support. Uptime and Buffer Stock: Track key customer installations uptime and work with planning team to maintain buffer stock near customer sites to proactively address potential supply shortages. Supply Allocation: Collaborate with production and repair factory planners to map out supply allocations for the open RMA backlog. Optimize resource allocation for timely resolution. Serve as Lead: Trainer and support for other case managers on program, process, customer interface and working internally as new programs develop for NPI and implemented into our global customer service team. What we need to see:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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 – Case Manager Analyst - Field Location: Will & DuPage Counties, IL Must reside in one of the following Zip Codes: 60606, 60607, 60608, 60609, 60610, 60611, 60612, 60614, 60622, 60623, 60624, 60632, 60639, 60644, 60647, 60651, 60653 This Case Management Analyst Field position is with Aetna’s Long-Term Services & Supports (LTSS) team and is a field-based position. The requirement is for candidates to travel up to 75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meeting contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable 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 – Case Manager Analyst - Field Location: Champaign, IL This Case Management Analyst Field position is with Aetna’s Long-Term Services & Supports (LTSS) team. The requirement is for candidates to travel 75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meeting contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case man

The Mid-Corp Relationship Manager is a strategic professional who closely follows latest trends in own field and adapts them for application within own job and the business. Typically a small number of people within the business that provide the same level of expertise. Excellent communication skills required in order to negotiate internally, often at a senior level. Developed communication and diplomacy skills are required in order to guide, influence and convince others, in particular colleagues in other areas and occasional external customers. Accountable for significant direct business results or authoritative advice regarding the operations of the business. Necessitates a degree of responsibility over technical strategy. Primarily affects a sub-function. Responsible for handling staff management issues, including resource management and allocation of work within the team/project. Responsibilities: Calls on clients to deepen relationships and proactively owns, responds to, uncovers and anticipates future needs, roadblocks or risks and expectations Introduces solutions to clients in building and strengthening an effective portfolio; Works with product specialists and subject matter experts to structure innovative and customized solutions that meet clients’ individual needs Works closely with Case Manager on the on-boarding and retention of clients, ensuring the appropriate “Know Your Client” (KYC) and other compliance deliverables are met; Identifies cross-sell opportunities to deepen and increase share of wallet; Maximizes client experience by proactive sharing markets updates, trend and intelligence Drives innovation in the solutions we provide clients and further developing our business where necessary and appropriate Execution of strategic initiatives launched centrally at all levels (Group, Bank, commercial market and EIB) Networks with clients to identify