Paradigm · 9 hours ago
Clinical Solutions Associate II
United States
Part-time
Remote
Mid Level
3+ years expParadigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. As a Clinical Solutions Associate II, you will support exceptional patient management and strengthen partnerships across the Clinical Operations team, ensuring seamless coordination of patient cases and timely delivery of commitments.
Health CareHospitalMedical
Responsibilities
Partner with Director Clinical Services to manage the development of all new contracts, including participation in clinical conferences, and tracking of appropriate documents
Participate and /or facilitate and document results of all patient related conferences as requested by the Director Clinical Services
Ensure smooth administrative management of all assigned Paradigm cases, including tracking and routing of patient reimbursement requests, PRNs, PNFs and PCA requests
Track all customer deliverables to ensure timely submission that meet company Standards of Performance. Initiate appropriate action plans for late reports or contracts
Provide instruction to the administrative team regarding the entry of accurate patient demographic data in the electronic data collection system
Participate in the report review process as required by established workflow procedures
Serve as primary point of administrative contact for case specific Network Manager, including providing information and direction regarding deliverable timelines, as well as appropriately managing and directing case specific requests and inquiries from the Network Manager, patient/family or provider
Liaise with assigned administrative Network Business contacts, providing education regarding Paradigm internal process, product revision or implementation and specific Network Manager performance issues
Collaborate with other internal departments (Contracting, Bill Review, Accounting) to address and resolve specific patient / provider issues
Participate in procedural and workflow development for the CSA team as well as the overall Clinical Operations team
Participate in company projects requiring CSA II representation, as requested by management
The case load is equitably distributed among all CSA II roles
All CSA II will participate in the creation of and adopt CSA best practices
The CSA team is expected to provide backup coverage for each other as requested by the manager
Qualification
Required
Bachelor's degree from an accredited educational institution preferred
Three to five years progressively responsible customer service experience
Three years related experience in provider relations or health care
Strong medical background to include comprehensive understanding of medical terminology and health care principles and practices
Demonstrated ability to multi-task in a fast paced work environment
Experience with various computer applications including Microsoft Office, Outlook, Word and Excel
Excellent oral communication skills and phone presence
Ability to read and comprehend instructions, correspondence, memos, and medical/patient reports
Ability to write correspondence and memos and utilize e-mail communication effectively
Ability to present information in one-on-one and small group situations
Excellent analytical skills -- ability to define problems, collect data, establish facts, and draw valid conclusions
Ability to interpret a variety of instructions and deal with abstract and concrete variables
Demonstrated ability to analyze difficult situations, problems, and data; use good judgment and decision making
Any combination of education/experience and knowledge that demonstrates the ability to perform the functions of the position will be accepted
Benefits
Health and wellness– We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
Financial incentives – Paradigm’s financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest.
Volunteer time– We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year.
Learning and development: One of Paradigm’s core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.
Company
Paradigm
Paradigm achieves leading clinical and financial results for catastrophic and complex claims.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Neuberger Berman Capital Solutions
2025-07-02Private Equity
2018-09-20Acquired
Leadership Team
D
D. Nathan
Founder
Recent News
2025-12-10
2025-07-02
Company data provided by crunchbase