[Hiring] Senior Provider Engagement Specialist @Paradigm

Role Description

Paradigm is hiring a full-time, remote Senior Provider Engagement Specialist. The Senior Provider Engagement Specialist is responsible for supporting the implementation, ongoing management, engagement, and maintenance of contracted provider relationships within the Paradigm Network nationally. This role serves as a key Provider Management resource for provider education, relationship management, issue resolution, and complex provider inquiries and escalations across Workers’ Compensation, Auto, Group Health, and other current or future business lines. The Senior Provider Engagement Specialist independently researches and analyzes provider-related matters, coordinates appropriate resolution with internal and external stakeholders, and maintains clear and accurate documentation of provider activities and outcomes.

The role requires sound judgment, strong analytical and communication skills, and the ability to manage assigned work through resolution while recognizing when additional cross-functional or leadership involvement is appropriate.

• Build and maintain strong, collaborative relationships with contracted providers, serving as a trusted resource throughout the provider lifecycle.
• Manage provider onboarding, engagement, education, training, and ongoing support to promote understanding of program, contractual, and operational requirements.
• Independently research and resolve complex provider inquiries, concerns, disputes, and escalations, using sound judgment to determine appropriate resolution and follow-up.
• Partner with Network Development, Credentialing, Provider Data Management, Operations, Billing, Finance, and other teams to address provider needs and resolve issues.
• Review provider agreements, fee arrangements, and related information to support contract adherence, provider education, and issue resolution.
• Identify trends, recurring concerns, relationship risks, performance issues, and network needs, recommending appropriate education, corrective action, or escalation.
• Maintain accurate, timely, and audit-ready documentation while ensuring compliance with contractual, regulatory, HIPAA, information security, and company requirements.
• Represent Paradigm Specialty Networks professionally in provider meetings, cross-functional initiatives, conferences, trade shows, and networking events.

Qualifications

• Bachelor’s degree in Business Administration, Healthcare Administration, or a related field, or an equivalent combination of education and relevant experience.
• 5–7 years of experience in Workers’ Compensation, provider relations, provider network management, managed care, healthcare operations, or a related healthcare environment.
• Strong knowledge of provider network operations and relationship management, with the ability to interpret provider agreements, fee arrangements, and operational requirements.
• Demonstrated ability to independently research and resolve complex issues, identify root causes, exercise sound judgment, and develop effective solutions.
• Excellent communication and relationship-building skills, with the ability to collaborate effectively with providers, clients, internal partners, and leadership.
• Strong organizational skills and attention to detail, with the ability to manage multiple priorities, deadlines, follow-up activities, and accurate documentation.
• Proficiency with Microsoft Office and healthcare business systems; experience with CRM, case management, or provider network systems preferred.
• Salesforce and specialty provider network experience are a plus.

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 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.