Care Coordination & Payer Relations Leader

Community Health Partnership of Illinois (CHP); Chicago (IL); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

HSA and Health Tools

PTO and Holidays

403(b) Retirement Plan

Life and AD&D Insurance

Short-Term Disability

Job summary

Community Health Partnership of Illinois (CHP) is seeking an experienced Manage Care Coordinator to oversee managed care coordination, insurance payer relationships, and patient care transitions across CHP locations. This role serves as a key liaison between CHP, MCOs, providers and patients to ensure effective coordination of care.

The position supports value-based care initiatives, manages insurance-related processes, and improves access to services.

Qualifications

• Active professional license as RN, LCPC, LCSW, or related licensed professional.
• RN preferred and BLS/ACLS certifications required.

Responsibilities

• Serve as liaison between CHP and managed care organizations (MCOs) including Medicaid and Medicare Advantage.
• Monitor quality metrics, value-based care goals, and incentive programs (HEDIS/UDS).
• Manage MCO/third-party contracts, document terms, and report to leadership.
• Coordinate insurance authorizations, referrals, and benefit verification with clinical staff.
• Facilitate continuity of care across primary, specialty, ED, and inpatient settings.
• Lead care coordination with interdisciplinary teams and care plans.
• Support compliance with policies, healthcare regulations and confidentiality requirements.

Skills

Leadership

Communication

Organizational

Problem-solving

Critical thinking

Care coordination

Education

RN license

LCPC license

LCSW license

BLS certification

ACLS certification

Related licensed professional

Tools

Microsoft Office

Job description

Community Health Partnership of Illinois (CHP) is seeking an experienced Manage Care Coordinator to oversee managed care coordination, insurance payer relationships, and patient care transitions across CHP locations. This role serves as a key liaison between CHP, MCOs, providers and patients to ensure effective coordination of care.

The position supports value-based care initiatives, manages insurance-related processes, and improves access to services.