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.

Paradigm is seeking a Home Health Referral Care Coordinator to support our Home Health referral coordination team. This fully remote role is responsible for coordinating home health and IV therapy referrals, serving as a key point of contact between providers and injured workers, and ensuring timely, accurate referral processing. The position is full-time, Monday–Friday, 12:00 p.m. – 8:30 p.m. EST, and plays a critical role in delivering high-quality care coordination and service excellence.

Responsibilities:

• Provide staffing for home health and IV therapy referrals, assist Intake Department with taking new home health referrals as needed.
• Promote positive public relations with referral sources and identify Network providers to staff and accept home health referrals.
• Ensure accuracy of demographic data, contacting appropriate referral source to obtain orders, medical records, and any needed documentation to staff cases.
• Address inquiries and questions in a timely, professional manner. Provide excellent follow up as appropriate with supervisor, coworkers and/or residents.
• Identify local vendors to provide needed services, negotiate rates when necessary and provide single case agreement with vendor to ensure appropriate pricing and margins.
• Answer phone calls, accurate document management, intake referrals, letters of authorization, and pricing negotiations. Demonstrate appropriate knowledge of Injured Workers' rights, ensure privacy, dignity, and well-being of Injured Workers.
• Positively support the mission, values, and vision of Paradigm through effective communication with internal and external customers, serve as positive role model, demonstrate excellent customer service, and comply with all applicable regulatory requirements and Quality Assurance initiatives.
• Provide a work environment free from all illegal and discriminatory behavior and harassment, including sexual harassment.
• Assist with on-call duties on assigned weekends with compensation.

Qualifications: 

• Education/Training: Some College and/or Medical Background, LPN preferred.
• Bilingual Spanish / English speaking strongly preferred
• Experience: Work Comp Insurance, Referrals, and Authorizations experience preferred.
• Skill(s): Proficient reading, writing, grammar, and mathematics skills; knowledge of medical terminology; good interpersonal relations and communicative skills; moderate PC skills with emphasis on accuracy; excellent organizational and prioritization skills with ability to multi-task. Computer Proficient: MS Office, Word, Excel, and PowerPoint.
• Equipment/Machinery Used: Standard office equipment including phones, scanners, fax, laptop/PC, copiers, various computer programs, etc.
• Able to cooperate and work cohesively with all co-workers, management, and external customers. Able to plan and complete job duties with minimal supervisory direction, utilize sound judgment, tact, diplomacy, and compassion in verbal and written communication.
• Able to demonstrate appropriate follow up with supervisor, co-workers or residents regarding reported complaints, problems, and concerns.
• Knowledgeable of injured workers’ rights and ensure an atmosphere which allows for the privacy, dignity, and well-being of each injured worker. Ensure confidentiality of all data, including injured worker’s demographics, employee, and operations data.
• Able to complete requirements for in-service training, maintain acceptable attendance and appropriate dress code.

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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