Telephonic Case Review / Case Manager

Paradigm

1d • Hybrid

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 role of a nurse case manager at Paradigm.
We are seeking a Telephonic Case Review / Case Manager with compact RN license to work Monday - Friday, 8 AM to 5 PM. Experience in Utilization Review (UR) and worker's compensation case management is required.
This role is a hybrid position involving both casualty medical file reviews and telephonic case management, requiring flexibility, strong self‑motivation, and a high level of attention to detail. As a Telephonic Case Manager (TCM), you will provide remote medical case management services to injured individuals, many of whom were industrially injured. This position will assist consumers in their recovery so that they may return to the highest level of function as possible. The TCM ensures that medical services are coordinated and assessed frequently, vocational options are explored with the injured worker and their employers, and pre-injury employment or alternate employment is secured. In the role of TCM, this position works with all parties to the claim including: the injured person, the claim’s examiner, employer, attorneys (plaintiff and defense) and medical providers.
At Paradigm, People Come First
It's more than a job. It's a passion. Work at Paradigm, and you’ll find deep satisfaction knowing you’re making a profound difference in people’s lives.
Meaningful work: better outcomes for all isn’t just our tagline. It’s what guides us to do our best—every day. At Paradigm, you’ll find an authentic connection between the work you do and your passion for making a difference in the world.
Exceptional people: You'll work alongside smart people who share a commitment to excellence and a dedication to service. We're not here just for a "job." We're here to transform lives.
Collaborative culture: At Paradigm, a spirit of collaboration and care is evident in everything we do. We promote a culture of inclusivity and value diversity of all kinds including thought, knowledge, and experience. No matter the team, everyone works together toward a common goal to deliver exceptional outcomes.

Requirements

• Unencumbered compact RN license required
• Utilization Review (UR) and worker's compensation case management experience required
• Professional licenses or certifications required to meet qualifications for this position must be current, unrestricted and allow for practice within a state or territory of the United States

Nice To Haves

• CCM strongly preferred. 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.

Responsibilities

• provide remote medical case management services to injured individuals, many of whom were industrially injured
• assist consumers in their recovery so that they may return to the highest level of function as possible
• ensure that medical services are coordinated and assessed frequently
• vocational options are explored with the injured worker and their employers
• pre-injury employment or alternate employment is secured
• works with all parties to the claim including: the injured person, the claim’s examiner, employer, attorneys (plaintiff and defense) and medical providers

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 from our Dedicated Training Department that offers an 8-12 week new hire onboarding program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 11-50 employees