Clinical Solutions Associate II

Location: Tennessee, USA• Tampa, FL, USA• Texas, USA• North Carolina, USA• Georgia, USA
Req Number: Req #1646

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.

We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.

Watch this short video for a brief introduction to Paradigm.

Join Paradigm as a Clinical Services Associate II, a fully remote position, where you’ll play a vital role in supporting exceptional patient management and strengthening key partnerships across our Clinical Operations team. In this position, you will partner closely with the Director of Clinical Services (DCS) and Network Manager (NWM) to ensure seamless coordination of patient cases, timely delivery of all customer commitments, and strong administrative oversight of contract management.

As a CSA II, you’ll be at the center of communication flow—facilitating patient‑related conferences, supporting provider and network relationships, and ensuring accurate, proactive case administration. Your work directly contributes to delivering well‑conceived management plans that make a meaningful impact on patient outcomes.

This role is ideal for someone who thrives in a fast‑paced environment, brings strong analytical and customer service skills, and is passionate about improving processes, supporting clinical teams, and delivering high‑quality results. With a diverse workload, opportunities to collaborate across departments, and involvement in company projects, this position offers both challenge and growth.

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.

Qualifications:

• Education: Bachelor’s degree from an accredited educational institution preferred.
• Experience: 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.
• Language: 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.
• Reasoning Ability: 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.

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Paradigm 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.
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.
Paradigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.
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.
As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster

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Equal employment opportunity, including veterans and individuals with disabilities.

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