Job Description:


Location: Tampa, FL, USA• Houston, TX, USA• Denver, CO, USA• Florida, USA• Texas, USA• Colorado, USA
Req Number: Req #1232

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

Paradigm is looking for a full-time, remote Clinical Referral Manager. This position is accountable for driving revenue growth by implementing processes to analyze and direct enterprise referrals for consideration for service via a risk bearing product. Duties and responsibilities include, but are not limited to:

• Evaluate incoming and existing referrals to determine appropriate product placement based on specified criteria.
• Assess clinical conditions, treatment plans, and required resources.
• Escalate referrals that need additional or advanced services.
• Identify key stakeholders; build and maintain strong relationships with stakeholders to ensure effective handling of catastrophic referrals.
• Provide education and support to customers regarding Paradigm products and services.
• Analyze referrals, develop strategies to increase the scope of referrals, and track and maintain data on referral conversions.

EDUCATION & EXPERIENCE REQUIRED:

• Registered Nurse (with active, unencumbered license)
• Minimum of 3-5 years’ experience in catastrophic case management, referral intake or sales
• Experience in insurance preferred.
• Intermediate to advanced level computer experience and Windows software, proficient in Microsoft product suite with advanced skills in Excel.

KNOWLEDGE SKILLS & ABILITIES:

• Exceptional critical-thinking and creative problem-solving skills with proven ability to collaborate with others to identify alternatives and drive to resolution.
• Strong communication and facilitation skills including the ability to resolve issues and build consensus among groups of diverse internal/external stakeholders.
• Ability to deliver effective presentations to internal and external customers.
• Ability to work effectively autonomously and/or in a matrixed environment.
• Ability to review and assess complex medical records and convey pertinent information to non-medical stakeholders.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Other details

PI255269723

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