Job type full-time
Not provided by employer
Full job description
Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex and catastrophic injuries and diagnosesThe 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 providersDeep clinical expertise is the foundation for every part of paradigm’s business, including its risk-based clinical solutions, case management services, high-value specialty networks, home health, and payment integrity programsParadigm is headquartered in walnut creek, california, with offices across the u.sFor more information, please visit www.paradigmcorp.com.
The case manager is responsible for the medical case management of work related injuries, which includes assessment, planning, coordination, implementation and evaluation of injured/disabled individualsA case manager works independently using his/her own discretion to assist injured workers/consumers in their recovery so that they may return to the highest level of function as possibleThe case manager works with all parties to the claim including: the injured person, the claim’s examiner, employer, attorneys (plaintiff and defense) and medical providers.
**remote position, requires ca rn license but does not require ca residency**
Duties and responsibilities:
Accepts cases for referral and management in accordance with medical case management standards of practices and established caseload.
Counsel, direct and motivate consumers to reach their highest level of function.
Establishes relationships and maintains communications with consumers, families, providers, paradigm’s carrier clients and employersEnsures that all communication is culturally sensitive and meets requirements to maintain injured worker confidentiality.
Completes accurate and timely written reports in accordance with paradigm documentation standards.
Ensures that case management plan is implemented and care is coordinated to ensure achievement of case management interventionsDocuments progress towards achievement of case management intervention and evaluate progress on an ongoing basis, modifying the case management plan if indicated.
Assist sales/marketing team as needed in order to build caseloadDevelop solid relationships with customers in order to assure repeat business.
Qualification requirements:
Current, unrestricted registration as a licensed nurse (rn)
Ca rn license, multi state license
Case managers may also need regional or national certifications and must adhere to the standards of practice outlined by the specific national certifying body or the jurisdictionally accepted standards of practice.
Work comp case management experience strongly preferred.
Ccm certifications preferred
Competencies
Exceptional time management and organization skills are requiredA full-time case manager is responsible for approximately 65 files that all require contact and reporting within specific timelines.
The ability to communicate effectively with a wide range of people on a daily basis utilizing both verbal and written communication.
Flexibility, versatility, and problem solving – this role works at a fast pace.
Technology proficiency – case managers at paradigm ccs use an advanced case management software solution to do their workA laptop and cell phone are used daily.
Strong clinical skills – case managers do not provide direct patient care but they rely on their strong clinical skills to exercise discretion and make an independent judgement of treatment and progress in order to make an impact on their injured workers.
The desire to help others and yourself succeed.
Self-motivated and ability to work independently.
Proven decision-making and critical thinking skills, requiring little supervision.
Problem solving and conflict resolution/negotiation skills.
Pm19
Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming livesWe’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 serveFor 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.
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