Provider Relations Specialist

Paradigm • Tampa, FL

2d • $68,500 - $92,000 • Remote

About The Position

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.
We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.
Watch this short video for a brief introduction to Paradigm.
The Provider Relations Specialist supports Paradigm's provider network strategy by assisting in relationship management, contracting activities, and vendor coordination. This role is responsible for helping to maintain strong provider relationships, coordinating single case agreements, and supporting cost-effective care solutions. The associate will contribute to the execution of strategies developed by the Director and will serve as a liaison with providers, vendors, and internal stakeholders to ensure alignment with Paradigm's financial and operational goals.
This is a remote work opportunity

Requirements

• Excellent provider-facing and internal communication skills.
• 4+ years of experience in provider relations and contract development.
• Excellent written and verbal communication skills.
• Familiarity with reference-based pricing models, single case agreements, and facility contracting concepts.
• Solid organizational skills including attention to detail and multitasking skills.
• Strong working knowledge of Workers Compensation fee schedules, CMS methodology, medical coding and other standard billing practices.
• Strong organizational skills and ability to manage multiple priorities effectively.
• Bachelor's Degree in appropriate field of study or equivalent work experience.

Nice To Haves

• Some Commercial healthcare experience strongly preferred.

Responsibilities

• Serve as a day-to-day point of contact for providers regarding inquiries, documentation, and follow-up on active negotiations.
• Facilitate key provider relationships including performing monthly reviews, QBR's and annual stewardships with select providers.
• Support management of key vendor/partner relationships including but not limited to participating in monthly reviews, QBR's and annual stewardships.
• Support the execution and tracking of single case agreements (SCAs), letters of agreement (LOAs), and other provider arrangements.
• Maintain accurate contract records and provider contact logs, support preparation of documentation and materials for provider discussions.
• Assist in coordinating provider onboarding and education related to Paradigm programs and expectations.
• Help monitor vendor deliverables and escalate issues to the Director as appropriate.
• Assist in data tracking and reporting related to vendor and partner performance.
• Compile and analyze data to support provider engagement, payment strategy, and network optimization initiatives.
• Prepare summary reports or visualizations for internal and external stakeholders as requested.
• Assist with identifying trends or provider issues based on contract and billing data.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree