Paradigm is hiring a **Clinical Referral Manager** for a remote, full-time, benefited position. The **Clinical Referral Manager** provides clinical support for the Catastrophic Referral Intake Unit. The schedule for this position is Monday through Friday, 8 AM to 5 PM Pacific time (9 AM to 6 PM Mountain time, 10 AM to 7 PM Central time, or 11 AM to 8 PM Eastern time). **Responsibilities:** - Assist with assignment of the Primary Medical Team and Network Managers to new referrals. - Evaluate incoming and existing referrals to determine appropriate product placement based on specified criteria. - Assist the Catastrophic Referral Intake Unit in reviewing new referral escalations for appropriate product placement. - Assess clinical conditions, treatment plans, and required resources. Escalate referrals that need additional or advanced services. - Identify key stakeholders and responsible parties for each referral. Build and maintain strong relationships with stakeholders to ensure effective handling of catastrophic referrals. - Provide education and support to customers regarding Paradigm products and services. - Review active field case management files to identify opportunities for conversion to risk-bearing products. - Analyze referrals that were unstaffed or withdrawn, gather relevant data, and provide insights to the sales team for potential conversion. - Develop strategies to increase the scope of referrals considered for conversion and collaborate with other business units to implement these processes. - Track and maintain data on referral conversions, including revenue and cases that were not successfully converted. **Qualifications:** **EDUCATION & EXPERIENCE REQUIRED:** - Registered Nurse (with active, unencumbered license) - Minimum of 3-5 years' experience in catastrophic case management, referral intake or sales - Experience in insurance preferred. - Demonstrated ability to define, manage and modify operational processes and workflows. - Demonstrated ability to work collaboratively to address operational and customer requests. - Intermediate to advanced level computer experience and Windows software, proficient in Microsoft product suite with advanced skills in Excel. **KNOWLEDGE SKILLS & ABILITIES:** - Exceptional critical-thinking and creative problem-solving skills with proven ability to collaborate with others to identify alternatives and drive to resolution. - Strong communication and facilitation skills including the ability to resolve issues and build consensus among groups of diverse internal/external stakeholders; Ability to deliver effective presentations to internal and external customers. - Ability to work effectively autonomously and/or in a matrixed environment; Ability to be flexible and responsive to change. - Excellent interpersonal skills with an ability to influence and lead through change. - Ability to review and assess complex medical records and convey pertinent information to non-medical stakeholders - Experience working as a Network Manager and using EDDG preferred **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 employer-matched HSA contributions. - **Vacation - **We believe strongly that work-life balance is good for you and for our company. We offer paid time off, paid holidays, and a personal holiday. - **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 through our LEAP training program. #LI-Remote