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.

We are seeking a full-time, remote Home Health Referral Care Coordinator. This position is responsible for performing a variety of duties including answering phone calls, document management, intake referrals, completion of letters of authorization, price negotiations, and staffing home health and IV therapy referrals as well as serve as point of contact between Providers and Injured Workers.
Hours: Monday – Friday, 12p-8:30p ET.

Duties and 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 supervisors, coworkers and/or residents.
• Identify local vendors to provide needed services, negotiate rates when necessary and provide single case agreement with vendors 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 models, demonstrate excellent customer service, and comply with all applicable regulatory requirements and Quality Assurance initiatives.

• Some College and/or Medical Background, Bilingual preferred, not required.
• Work Comp Insurance, Referrals, and Authorizations experience preferred.
• 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.
• 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.

• 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.
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.