Clinical Referral Manager - RN
Paradigm is looking for a full-time, remote Clinical Referral Manager. This position is accountable for driving revenue growth by implementing processes to analyze and direct enterprise referrals for consideration for service via a risk bearing product. Duties and responsibilities include, but are not limited to:
* Evaluate incoming and existing referrals to determine appropriate product placement based on specified criteria.
* Assess clinical conditions, treatment plans, and required resources.
* Escalate referrals that need additional or advanced services.
* Identify key stakeholders; build and maintain strong relationships with stakeholders to ensure effective handling of catastrophic referrals.
* Provide education and support to customers regarding Paradigm products and services.
* Analyze referrals, develop strategies to increase the scope of referrals, and track and maintain data on referral conversions.
EDUCATION & EXPERIENCE REQUIRED:
* Registered Nurse (with active, unencumbered license)
* Minimum of 3-5 years' experience in catastrophic case management, referral intake or sales
* Experience in insurance preferred.
* Intermediate to advanced level computer experience and Windows software, proficient in Microsoft product suite with advanced skills in Excel.
KNOWLEDGE SKILLS & ABILITIES:
* Exceptional critical-thinking and creative problem-solving skills with proven ability to collaborate with others to identify alternatives and drive to resolution.
* Strong communication and facilitation skills including the ability to resolve issues and build consensus among groups of diverse internal/external stakeholders.
* Ability to deliver effective presentations to internal and external customers.
* Ability to work effectively autonomously and/or in a matrixed environment.
* Ability to review and assess complex medical records and convey pertinent information to non-medical stakeholders.