Senior Manager, Client Implementation - Military veterans preferred

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The 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 providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

The Senior Manager, Client Implementation, is responsible for leading the successful implementation of new Healthcare Solutions clients and internal projects as needed. This position will ensure our team delivers consistent and efficient results, positioning our approach as best practice, and ultimately exceeding client expectations. The Senior Manager, Client Implementation is a subject matter expert of Healthcare Solutions capabilities and can clearly and accurately communicate with clients to deliver successful ongoing execution of Healthcare Solutions programs as well as support production of outcomes and enhanced functionality. This role holds accountability for governance of the client implementation process inclusive of both internal and external requirements.

This is a remote work opportunity

DUTIES AND RESPONSIBILITIES:

• Responsible for management and oversight of new client implementations and pre-sale service for the Healthcare Solutions business unit
• Manage all implementation activities for the client including setting up a customized plan that positions us as easy to work with and allows us to exceed client expectations
• Facilitate and manage transfer of claims files necessary for pre-sale savings analysis
• Lead and manage implementation activities with Sales, Account Management, Operations, IT, and other internal teams as needed
• Manage client implementation meetings (weekly/bi-weekly/monthly depending on timing)
• Create, manage and maintain implementation schedule, action items logs and detailed documentation in support of implementation
• Ensure documentation of all agreed upon requirements and processes o Act as SME and coordinate all internal setups (sftp setup, eligibility, claims, invoicing, reporting, program, special needs, etc.)
• Act as SME and manage launch communications with clients for review and approvals and with internal teams for the setup of member communication process o
• Maintain communications with all parties
• Oversight of existing account changes and ongoing maintenance
• Evaluate customer requests and assess market opportunities across departments to determine feasibility and act as an operational representative for client-facing conversations. This requires an understanding of the scope of our Healthcare Solutions products, clinical services, understanding of jurisdictional and compliance requirements, and member engagement best practices
• Manage ongoing eligibility and claims processing and coordinate special requests in support of client partnership
• Coordinate follow up and ensure completion of client audits
• Manage, plan and QA any client specific communication updates for Healthcare Solutions programs (e.g. release notes)
• Address day to day client concerns or troubleshooting
• Facilitate development and coordination of contracting language for new client contracts and renewals
• Work with Sales lead and Legal on negotiation and finalization of client contracts, proposing business language to clarify program details and close gaps in support of the sales process
• Review new client contracts to identify and/or evaluate customer guidelines and requirements
• Coordinate with internal teams to review and facilitate contract finalization
• Manage internal cross-functional projects, coordinating tasks across teams with awareness and understanding of impact on our clients
• Facilitate the Quality, Innovation and Compliance Committee (QICC) monthly meeting, managing related tasks, meetings and status reporting to ensure compliance with all relevant regulations and standards
• Develop, implement, and maintain policies and procedures coordinating with other internal areas related to Healthcare Solutions Operations including new industry/legal requirements, compliance and governance
• Stay current with changes in regulations (Medicare, Medicaid, etc.) and industry best practices
• Oversight of product enhancements with client perspective in mind, participating in UAT and regression testing as needed •
• Travel as required to meet business objectives

QUALIFICATION REQUIREMENTS:

• Bachelor's degree required
• Advanced degree, project management or similar certification encouraged
• Prior client relationship experience required
• 5 years of related experience in a health care environment
• Excellent oral and written communication skills. Ability to present information in one-on-one and small group situations
• Excellent analytical skills – demonstrated ability to independently identify, define, and resolve problems; ability to 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; ability to use good judgment and decision-making skills.
• Savvy with clients; adaptable to change and can manage the unexpected
• Ability and willingness to travel as needed
• Problem solving and conflict resolution skills
• The ability to prioritize and multi-task
• The ability to work under pressure and meet deadlines
• Demonstrated proficiency in Microsoft Office Job Description

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.