Senior Provider Engagement Specialist - Workers' Compensation

Paradigm; Tennessee; Remote; USD 90,000 - 130,000; Full time

Job summary

Paradigm is seeking a Senior Provider Engagement Specialist for a full-time remote role. You will support implementation, management, and maintenance of contracted provider relationships nationwide, acting as a primary resource for education, issue resolution, and escalations across multiple lines of business.

The role emphasizes independent research, cross-functional collaboration, and meticulous documentation, requiring strong analytical and communication abilities to drive effective provider

Qualifications

• Bachelor’s degree or equivalent in a related field.
• 5–7 years of experience in workers’ comp, provider relations, or managed care.
• Ability to interpret provider agreements, fees, and operational requirements.
• Strong communication and relationship-building skills.
• Excellent organizational skills and documentation accuracy.

Responsibilities

• Build and maintain strong relationships with contracted providers across the provider lifecycle.
• Manage onboarding, engagement, education, training, and ongoing support.
• Research and resolve complex provider inquiries and escalations with sound judgment.
• Collaborate with Networks Development, Credentialing, Data Management, Operations, Billing, and Finance.
• Review provider agreements and related information to support contract adherence.
• Identify trends, risks, and needs; recommend education or escalation.
• Maintain audit-ready documentation compliant with regulatory and company requirements.
• Represent Paradigm Specialty Networks at meetings, conferences, and events.

Skills

Relationship management

Communication

Organizational skills

Problem solving

Attention to detail

CRM systems

Education

Bachelor’s degree in Business or Healthcare Administration

Tools

CRM

Case management systems

Provider network systems

Salesforce

Job 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.

Key Responsibilities:

• 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.