Clinical Services Associate - Catastrophic Care Management
Posted on: March 22, 2020
Description: For almost 30 years, Paradigm has been the industry
leader in solving complex health care challenges and improving
lives. With the most connected and experienced team in health care,
we define and deliver outcomes that exceed financial and health
expectations for our clients, as well as for individuals and their
families.Paradigm delivers its solutions through three divisions:
Catastrophic Care Management, Complex Care Solutions and Specialty
Networks. The Paradigm divisions are built on expertise from five
best-in-class businesses: Paradigm Outcomes, The ALARIS Group,
Encore Unlimited, ForeSight Medical and Adva-Net. Founded in 1991,
Paradigm is headquartered in Walnut Creek, California with offices
across the U.S.SUMMARY:This position holds accountability for
providing operational support and backup to the clinical operations
team. Under the direction of the clinical operations team and the
supervision of the Director, Operations, this may include tracking
of customer deliverables, direct administrative support for the
Clinical Services Coordinator team, maintenance of data to ensure
accuracy and completeness in company-wide clinical databases and
applications, facilitation of patient management team communication
and general support of both the Network Manager and the Director of
Clinical Services to ensure proactive, well-conceived and executed
management plans.ESSENTIAL RESPONSIBILITIES include the following.
Other work-related duties may be assigned.
- Support of development of contract budgets, including
researching costs and ARCH budget entry and tracking of appropriate
documents to support contract development. Participate and /or
facilitate and document results of all patient related conferences
as requested by the Director of Clinical Services.
- Ensuring smooth administrative management of all assigned
Paradigm cases, including tracking and routing of all injured
worker related administrative forms.
- Complete data entry, quality assurance review of data, and
ongoing updating and maintenance of data in the patient database
based on information received from the Director of Key Accounts
(DKA), Clinical Services Coordinator (CSC), and/or Network Manager.
Track and process all electronic communications submitted to the
Case Related email boxes, complete assigned tasks in EDDG.
- Tracking of all customer deliverables to ensure timely
submission that meet company Standards of Performance. Initiate
appropriate action plans for late reports or contracts.
- Complete required procedural steps in the patient database,
Tasking Application and/or EDDG for documents submitted to the
customer and additional required actions upon customer acceptance
of a contract and/or agreement to contract completion.
- Utilize appropriate applications and databases to prepare or
create various documents that support the document production/case
management process including creating and updating Complexity
Calculations; distributing periodic reports to the Network
- Support timely development of Lifetime Medical Cost
- Participate in the report review process as required by
established workflow procedures.
- Collaborate with other internal departments (Contracting,
Claims, and Accounting) to address and resolve specific patient
- Other administrative duties as requested, including uploading
of records in ECL, documentation and archiving of patient notes,
research regarding patient specific issues and tracking of
deliverables as requested.
- Participate in company projects requiring representation from
the Clinical Services Coordinator team, as
- requested by management.
- Responsible for complying with Paradigm IT security requirement
- Responsible for safeguarding Paradigm or Paradigm related IT
- Responsible for notifying Paradigm of any IT security incidents
per Policy No. 16 Information Security Incident Management.PM19.
Requirements: QUALIFICATION REQUIREMENTS: To perform this job
successfully an individual must be able to perform each essential
duty satisfactorily. The requirements listed below are
representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
- Education: Bachelors degree from an accredited educational
- Experience: Two to five years progressively responsible
customer service experience. Related experience in provider
relations or health care preferred. Strong medical background
preferred, including 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.
- Must demonstrate an ongoing willingness and ability to learn
new database management programs.
- Acute attention to detail.
- 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
- 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.PHYSICAL DEMANDS: The physical demands described
here are representative of those that must be met by anemployee to
successfully perform the essential functions of this job.
Reasonable accommodations may be made toenable individuals with
disabilities to perform the essential functions.
- Physical Activities - While performing the duties of this job,
the employee is regularly required to reach with hands and arms and
talk or hear. The employee is frequently required to sit. The
employee is occasionally required to stand and walk.
- Perform some repetitive motion activities (keyboarding,
computer mouse use).
- Weight Lifted/Force Exerted - The employee's job does not
require weight to be lifted or force exerted.
- Vision Requirements - Specific vision abilities required by
this job include close vision and the ability to adjust focus.WORK
ENVIRONMENT: The work environment characteristics described here
are representative of those anemployee encounters while performing
the essential functions of this job. Reasonable accommodations may
bemade to enable individuals with disabilities to perform the
- Environment Conditions - While performing the duties of this
job, the employee does not work in wet or humid conditions
(non-weather), work near moving mechanical parts, work in high,
precarious places, endure outdoor weather conditions and/or endure
extreme cold or heat (non-weather).
- Noise Level - The noise level in the employee's work
environment is usually quiet to moderate.
Keywords: Paradigm, Lombard , Clinical Services Associate - Catastrophic Care Management, Executive , Lombard, Illinois
Didn't find what you're looking for? Search again!