RN Managed Care & Payer Liaison

Berliner Gasthausmission e. V.; Chicago (IL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

HSA and health management tools

PTO and company-paid holidays

403(b) retirement plan

Life and AD&D insurance

Short-term disability insurance

Accident insurance

Employee recognition and rewards

Job summary

Community Health Partnership of Illinois is seeking an experienced Manage Care Coordinator to oversee managed care coordination, insurance payer relationships, and patient care transitions across CHP locations.

The role supports value-based care initiatives, collaborates with clinical teams and Patient Health Navigators, and ensures compliance with insurance requirements while aiming to improve patient health outcomes.

Qualifications

• Active professional license as RN, LCPC, or LCSW.
• Current BLS and ACLS certifications.
• Strong leadership, communication, organizational, and problem-solving skills.
• Knowledge of Joint Commission accreditation standards and PCMH requirements.
• Proficiency with Microsoft Office.
• Understanding of healthcare regulations and patient care coordination.

Responsibilities

• Serve as liaison between CHP and managed care organizations (MCOs).
• Monitor quality performance metrics and value-based care goals.
• Manage and maintain MCO and third-party contracts and communicate terms to leadership.
• Prepare monthly reports on patient membership and enrollment by managed care plan.
• Coordinate insurance authorizations, referrals, and benefit verification with clinical staff.
• Support patients navigating Medicaid, Medicare, and other coverage requirements.
• Facilitate continuity of care between providers and facilities.
• Collaborate with interdisciplinary teams to develop and monitor patient care plans.
• Coordinate outreach for chronic disease management and preventive care.
• Identify gaps in care to improve engagement and outcomes.
• Connect patients with community resources addressing social determinants.

Skills

RN license

LCPC license

LCSW license

BLS

ACLS

Leadership

Communication

Organizational skills

Microsoft Office

Education

Professional licensure in nursing, counseling, or social work

Tools

Microsoft Office

Job description

Community Health Partnership of Illinois is seeking an experienced Manage Care Coordinator to oversee managed care coordination, insurance payer relationships, and patient care transitions across CHP locations.

The role supports value-based care initiatives, collaborates with clinical teams and Patient Health Navigators, and ensures compliance with insurance requirements while aiming to improve patient health outcomes.