Clinical Operations Sr. Specialist - 2025935

World Relief • Chicago, IL

1d • $77,200 - $86,000 • Hybrid

About The Position

The World Relief Health and Wellness Systems & Compliance Manager oversees operational systems and compliance infrastructure supporting Medicaid behavioral health services across World Relief Chicagoland. The role coordinates HIPAA compliance, Electronic Health Record (EHR) and billing systems, Medicaid and Managed Care Organization (MCO) administration, provider enrollment and credentialing, SharePoint resources, and technology partnerships. The Manager works across Health and Wellness, Finance, IT, Data, billing resources, vendors, and managed care organizations to maintain effective systems and support compliant service delivery.

The position is hybrid, with four days onsite and one work-from-home day per week. World Relief is a global Christian humanitarian organization that partners with churches and communities to respond to humanitarian and disaster needs, strengthen communities and resilience, and provide refugee and immigrant services and advocacy.

Requirements

• Mature personal Christian faith.
• Commitment to World Relief’s mission, vision, and values.
• Desire to serve and empower the Church to impact vulnerable communities.
• Ability to affirm and/or acknowledge World Relief’s Core Beliefs, Statement of Faith, Christian Identity, and the National Association of Evangelicals’ “For the Health of The Nation” document.
• Valid driver’s license, access to a reliable vehicle, and ability to pass MVR standards.
• 1–3 years of experience supporting compliance activities related to HIPAA, state regulations, insurance contracts, audits, and documentation requirements within healthcare, behavioral health, social services, or similarly regulated programs.
• Working knowledge of HIPAA and health information privacy practices.
• Experience working with electronic medical record systems or comparable systems and operational workflows.
• Ability and willingness to learn billing processes sufficiently to provide designated backup support.
• Strong systems-thinking, project coordination, process-improvement, communication, and organizational skills.
• Ability to translate complex systems, compliance, and administrative requirements into practical processes and resources for staff.
• Ability to work effectively with clinicians, program staff, Finance, IT, Data, vendors, billing resources, Medicaid managed care organizations, and organizational leadership.

Nice To Haves

• Bachelor’s degree in healthcare administration, business, public health, health information management, social services, or a related field; equivalent relevant experience may be considered.
• 4–7 years of experience supporting clinical practice operations and compliance, including HIPAA, state regulatory requirements, insurance contracts, audits, and documentation standards within healthcare, behavioral health, social services, or similarly regulated programs.
• Experience with Medicaid billing systems, managed care, Medicaid enrollment, credentialing, or related administrative processes.
• Experience maintaining clinician licensure, Medicaid enrollment, credentialing, or continuing education tracking systems.
• Experience administering or developing SharePoint-based resources and workflows.
• Experience coordinating projects or operational systems across multiple programs, departments, or locations.

Responsibilities

• Coordinate operational HIPAA and health-information compliance activities, including developing, reviewing, implementing, and maintaining related policies, procedures, and staff resources.
• Identify privacy, security, or operational compliance concerns and coordinate follow-up with organizational leadership, IT, and subject-matter experts.
• Develop and maintain staff guidance, training resources, and operational tools related to HIPAA, EHR systems, Medicaid/MCO processes, and other assigned systems.
• Coordinate EHR configuration, maintenance, and improvement, including forms, templates, permissions, workflows, service configurations, and administrative processes.
• Coordinate Medicaid billing-system configuration and workflows with Finance, billing resources, EHR resources, and clinical leadership to support accurate billing, resolve system barriers, and improve processes.
• Develop billing-process and system proficiency to provide backup billing support during staff absences, workload increases, or other operational needs.
• Coordinate Medicaid MCO administrative requirements, including contracting, applications, renewals, recredentialing, implementation, and required organizational documentation.
• Maintain required Illinois HFS Behavioral Health Clinic enrollment and coordinate operational documentation and systems readiness for HFS, Medicaid, MCO, and other applicable administrative reviews.
• Oversee and coordinate systems and clinical audit requests, gathering required information and documentation and facilitating timely responses.
• Monitor changes in Medicaid, HFS, MCO, and related operational requirements and coordinate necessary updates to systems, workflows, procedures, and staff resources.
• Coordinate provider Medicaid enrollment, credentialing, and recredentialing, and maintain systems for tracking clinician licensure, renewal requirements, and continuing education documentation.
• Maintain and improve SharePoint sites and operational resources so current forms, procedures, guidance, and tools are accessible to staff.
• Maintain systems onboarding, role-change, and offboarding processes, coordinating access to EHR, Teams, SharePoint, billing platforms, and other systems.
• Create and maintain standardized forms, permissions, and system workflows across programs and locations.
• Identify opportunities to simplify administrative systems, reduce duplication, and improve coordination between program, administrative, and clinical teams.
• Serve as the primary operational liaison with IT, managed service providers, and designated technology or systems partners to address technology, access, privacy, and operational needs.
• Track technology and systems issues, coordinate resolution, and implement approved changes affecting the Microsoft suite and EHR.
• Maintain documentation of key systems, configurations, access processes, workflows, and operational procedures to support continuity and cross-departmental coordination.
• Coordinate with Data and program leadership to support reliable system configuration, data workflows, and reporting infrastructure.
• Provide leadership with timely information about unresolved systems issues, operational risks, and recommended improvements.
• Participate in department meetings, staff development opportunities, program trainings, community activities, and organizational events.
• Perform other duties as assigned.

Benefits

• Competitive benefits package for full-time employees.
• Employee discount program for full-time employees.
• Well-being program recognized with the Gold-level Cigna Healthy Workforce Designation.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed