Clinical Solutions Associate II

4 weeks ago

Tampa, United States Paradigm Full time

SUMMARY

:

This position holds accountability for the successful administrative partnership with the Director Clinical Services (DCS) and the Network Manager (NWM) in the overall management of contracts. This includes tracking of all customer deliverables that meet targeted timelines and reflect and support patient management, facilitation of patient management team communication and general support of both the Network Manager and the Director Clinical Services to ensure proactive and well-conceived management plans. In addition, the Clinical Solutions Associate II holds an administrative accountability, in partnership with Network Services, to designated Network Business Owners (or designees) to reinforce their full understanding and support of Paradigm process and direction.

DUTIES AND RESPONSIBILITIES:

Partner with Director Clinical Services to manage the development of all new contracts, including participation in clinical conferences, tracking of appropriate documents and development of budget and financials associated with the contract. Participate and /or facilitate and document results of all patient related conferences as requested by the Director Clinical Services. Research and document patient driven costs and provider rates that drive budget development and management. Utilize web driven and other electronic resources to identify potential costs, including use of CPT codes in the company’s electronic claims adjudication system. 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, budget and provider management, 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. Responsible for complying with Paradigm IT security requirement and policies. Responsible for safeguarding Paradigm or Paradigm related IT passwords. Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management.

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: 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.

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.

Other details Job Family Active Pay Type Hourly Min Hiring Rate $27.00 Max Hiring Rate $33.00 Apply Now

  • Clinical Services Coordinator II

    7 days ago

    Tampa, Florida, United States Paradigm Full time

    POSITION OVERVIEW The Clinical Solutions Associate II is responsible for providing effective administrative support to the Director of Clinical Services (DCS) and the Network Manager (NWM) in managing contracts. This role involves ensuring that all customer deliverables are tracked and submitted within established timelines, facilitating communication...

  • Clinical Operations Specialist II

    2 weeks ago

    Tampa, Florida, United States Paradigm Full time

    SUMMARYThis role is responsible for providing essential administrative support to the Director of Clinical Services (DCS) and the Network Manager (NWM) in the comprehensive oversight of contractual agreements. This includes monitoring all client deliverables to ensure they are completed within designated timelines, facilitating communication among patient...

  • Clinical Solutions Manager

    5 days ago

    Tampa, Florida, United States Apixio Full time

    About the RoleThe Clinical Solutions Manager is a key position at Apixio, responsible for the development and management of our clinical solutions, including MS and APR-DRG validation. This role requires expertise in healthcare payment methodologies and audit and review criteria to target key claims for review and recovery.Key ResponsibilitiesInventory and...

  • Personnel Support Associate II

    2 weeks ago

    Tampa, Florida, United States Orthopaedic Solutions Management Full time

    Job OverviewThis position requires on-site presence, working in the office from Monday to Friday.In this role, you will:Assist a thriving Orthopaedic practice by executing a range of HR-related functions, providing administrative support to the Human Resources Department and its staff across various divisions. You will report directly to the Talent...

  • Personal Banker Associate II

    2 weeks ago

    Tampa, United States Fifth Third Full time

    Make banking a Fifth Third better® We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: Selected candidates are intended to become a Retail Personal Banker II after completing a 4-8 week on-boarding and education program that includes rotations in Operations...

  • Personal Banker Associate II

    3 weeks ago

    Tampa, United States Fifth Third Full time

    Make banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: Selected candidates are intended to become a Retail Personal Banker II after completing a 4-8 week on-boarding and education program that includes rotations in Operations...

  • Cloud Solutions Associate

    2 weeks ago

    Tampa, Florida, United States C4 Technical Services Full time

    Position: Cloud Solutions Associate Location: Remote C4 Technical Services is seeking a Cloud Solutions Associate to enhance our team by managing various aspects of technology solutions, including monitoring, installation, configuration, troubleshooting, and maintenance. In this role, you will deliver technical assistance, resolve issues, and ensure the...

  • Sales Associate II

    2 days ago

    Tampa, Florida, United States Tapestry Full time

    About the RoleThe Sales Associate II is a key member of our store team, responsible for delivering exceptional customer service and driving sales results in a fast-paced luxury retail environment. As a Sales Associate II, you will be the face of our brand, providing personalized experiences for our customers and exceeding their expectations.Key...

  • Civil Engineering Associate II

    2 weeks ago

    Tampa, Florida, United States H.W. Lochner, Inc. Full time

    Position Overview:H.W. Lochner, Inc. is seeking a qualified Engineer Associate II for multiple openings. This role is based in Tampa, FL and involves a variety of responsibilities essential to project success.Key Responsibilities:Preparation of technical documentation (20%)Development of comprehensive plan designs, including detailed outlines and material...

  • Retail Personal Banker Associate II

    1 month ago

    Tampa, United States Fifth Third Full time

    Make banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: Selected candidates are intended to become a Retail Personal Banker II after completing a 4-8 week on-boarding and education program that includes rotations in Operations...

  • Mortgage Loan Consultant II

    1 week ago

    Tampa, Florida, United States PennyMac Financial Services, Inc. Full time

    Position Title: Home Loan Specialist IIRequisition ID: Not specifiedLocation: United StatesPosition Type: RegularCategory: Mortgage OperationsEducation Requirement: Associate's DegreeExperience Required: Minimum of 3 yearsSalary Range: $40,000 - $60,000Company Overview: PennyMac Financial Services, Inc. (NYSE: PFSI) is a leading specialty finance company...

  • Medical Technologist II

    1 week ago

    Tampa, United States Creative Testing Solutions Full time

    Job Description SummaryUnder direct supervision, a Medical Technologist (MT) is responsible for performing routine high complexity testing of biological specimens. MTs work in a team environment to ensure timely and quality test results. Medical Technologists must maintain required competencies for applicable testing.Job DescriptionPRIMARY DUTIES AND...

  • Medical Technologist II

    7 days ago

    Tampa, United States Creative Testing Solutions Full time

    Job Description SummaryUnder direct supervision, a Medical Technologist (MT) is responsible for performing routine high complexity testing of biological specimens. MTs work in a team environment to ensure timely and quality test results. Medical Technologists must maintain required competencies for applicable testing.Job DescriptionPRIMARY DUTIES AND...

  • Mortgage Loan Consultant II

    7 days ago

    Tampa, Florida, United States PennyMac Financial Services, Inc. Full time

    Position Title: Home Loan Specialist IIRequisition ID: [Not Specified]Location: United StatesPosition Type: RegularCategory: Mortgage OperationsEducation Requirement: Associate's DegreeExperience Required: Minimum of 3 yearsSalary Range: $40,000 - $60,000Company Overview:PennyMac Financial Services, Inc. is a leading specialty finance company focused on...

  • Clinic Pharmacy Associate

    1 month ago

    Tampa, United States Orthopaedic Solutions Management Full time

    Job DescriptionJob DescriptionIn this role you will:Be responsible for capturing and dispensing all prescriptions in our formulary for all Work/Comp and Auto cases (with assigned attorney) as ordered by FOI dispensing providers for patients. The Dispensary Associate is responsible for updating and complying with all Federal, State and local agencies for an...

  • Mental Health Technician II

    4 weeks ago

    Tampa, United States BayCare Health System Full time

    At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network currently consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and 5,240 physicians. We foster a forward-thinking culture that's advancing superior health care. The Mental Health Technician II provides...

  • Medical Technologist II

    4 days ago

    Tampa, United States Creative Testing Solutions Full time

    Job Description SummaryBelow covers everything you need to know about what this opportunity entails, as well as what is expected from applicants.Under direct supervision, a Medical Technologist (MT) is responsible for performing routine high complexity testing of biological specimens. MTs work in a team environment to ensure timely and quality test results....

  • Systems Solutions Specialist

    2 weeks ago

    Tampa, Florida, United States CAE Full time

    Position OverviewThe Systems Solutions Specialist is an expert in the comprehensive design, evaluation, execution, and maintenance of technological systems, software, and various IT solutions. This role serves as the project leader for all designated initiatives.Key ResponsibilitiesTo ensure individuals with disabilities can perform essential functions,...

  • Mortgage Loan Consultant II

    1 week ago

    Tampa, Florida, United States PennyMac Financial Services, Inc. Full time

    Position Title: Home Loan Specialist IIRequisition ID: [Not Specified]Location: United StatesPosition Type: RegularCategory: Mortgage OperationsEducation Requirement: Associate's DegreeExperience Required: Minimum of 3 yearsSalary Range: $40,000 - $60,000Company Overview: PennyMac Financial Services, Inc. is a leading provider of mortgage banking services....

  • Clinical Therapist

    5 days ago

    Tampa, Florida, United States PT Solutions Full time

    As a valued member of the PT Solutions team, you will have the opportunity to make a meaningful impact on the lives of patients in need of inpatient and acute care services. As a Speech-Language Pathologist, you will be responsible for evaluating and treating patients with a range of conditions, including stroke, traumatic brain injury, head and neck cancer,...