{"schemaVersion":"jobsearcher.job.v1","id":"03d4604ee7d7be2cc878743e","url":"https://jobsearcher.com/jobs/03d4604ee7d7be2cc878743e","canonicalUrl":"https://jobsearcher.com/jobs/03d4604ee7d7be2cc878743e","title":"Quality Program Specialist - Worker's Compensation","description":"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.\n\nWe’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.\n\nWatch this short video for a brief introduction to Paradigm.\n\nParadigm is seeking a full-time Quality Program Specialist. The Quality Program Specialist is responsible for ensuring quality standards are compliant with customer requirements and consistent with company standards through quality audit processes and regular reporting. This role supports quality assurance through triage, escalation management, cause analysis, and collaboration with cross-functional teams. The specialist will lead monthly reporting of KPIs, document findings, and contribute to continuous process improvement initiatives. The ideal candidate will have strong analytical skills, a background in healthcare or workers’ compensation, and experience in quality management and operational problem-solving.\n\nDUTIES AND RESPONSIBILITIES:\n\nQuality Assurance and Input Management\n\nPerform quality audits on processes.\n\nTriage issues to appropriate teams based on complexity and urgency.\n\nEnsure consistent and accurate documentation and Process execution.\n\nEscalation and Problem Solving\n\nManage and track escalated issues, ensuring timely resolution and stakeholder communication.\n\nCollaborate with internal departments (e.g. Referral Management, Network development, Network Billing, Account Management, Network Services, IT) to resolve complex problems.\n\nAct as a liaison between internal teams and external when needed.\n\nRoot Cause Analysis and Continuous Improvement\n\nConduct monthly root cause analysis of recurring issues and escalations.\n\nIdentify patterns and trends to inform Management\n\nRecommend and support implementation of corrective actions and preventive measures.\n\nReporting and Documentation\n\nDevelop and maintain reports for KPIs, audit results, and process metrics.\n\nPresent findings to management and contribute to continuous improvement.\n\nMaintain documentation of audit, procedures, training materials, and process workflows.\n\nQUALIFICATION REQUIREMENTS:\n\nBachelor’s degree or equivalent work experience.\n\n2–4 years of experience in process improvement, operations analysis, or quality improvement.\n\nStrong analytical and problem-solving skills.\n\nProficiency in MS Office, especially Excel (pivot tables, charts, formulas).\n\nExcellent written and verbal communication skills.\n\nAbility to work independently and manage multiple priorities.\n\nPreferred:\n\nExperience in healthcare, workers’ compensation, or bill review operations.\n\nFamiliarity with quality management tools (e.g., root cause analysis, PDCA, Pareto charts).\n\nCertification in Six Sigma, Lean, or ASQ.\n\nParadigm Benefits:\n\nHealth 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).\n\nFinancial 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.\n\nVacation - 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.\n\nVolunteer 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.\n\nLearning 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.\n\nParadigm 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.\n\nParadigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.\n\nWe 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.\n\nAs a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster\n\n#LI-Remote\n\n#J-18808-Ljbffr","company":"Socket","rawCompany":"socket","city":"Phoenix","state":"AZ","isRemote":false,"isActive":false,"createdAt":"2026-09-13T03:52:08.246Z","occupations":[{"code":"11-3051.01","title":"Quality Control Systems Managers","slug":"quality-control-systems-managers"},{"code":"19-4099.01","title":"Quality Control Analysts","slug":"quality-control-analysts"},{"code":"19-5011.00","title":"Occupational Health and Safety Specialists","slug":"occupational-health-and-safety-specialists"}],"industries":[{"code":"621498","title":"All Other Outpatient Care Centers","slug":"all-other-outpatient-care-centers"},{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Quality Program Specialist - Worker's Compensation","description":"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.\n\nWe’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.\n\nWatch this short video for a brief introduction to Paradigm.\n\nParadigm is seeking a full-time Quality Program Specialist. The Quality Program Specialist is responsible for ensuring quality standards are compliant with customer requirements and consistent with company standards through quality audit processes and regular reporting. This role supports quality assurance through triage, escalation management, cause analysis, and collaboration with cross-functional teams. The specialist will lead monthly reporting of KPIs, document findings, and contribute to continuous process improvement initiatives. The ideal candidate will have strong analytical skills, a background in healthcare or workers’ compensation, and experience in quality management and operational problem-solving.\n\nDUTIES AND RESPONSIBILITIES:\n\nQuality Assurance and Input Management\n\nPerform quality audits on processes.\n\nTriage issues to appropriate teams based on complexity and urgency.\n\nEnsure consistent and accurate documentation and Process execution.\n\nEscalation and Problem Solving\n\nManage and track escalated issues, ensuring timely resolution and stakeholder communication.\n\nCollaborate with internal departments (e.g. Referral Management, Network development, Network Billing, Account Management, Network Services, IT) to resolve complex problems.\n\nAct as a liaison between internal teams and external when needed.\n\nRoot Cause Analysis and Continuous Improvement\n\nConduct monthly root cause analysis of recurring issues and escalations.\n\nIdentify patterns and trends to inform Management\n\nRecommend and support implementation of corrective actions and preventive measures.\n\nReporting and Documentation\n\nDevelop and maintain reports for KPIs, audit results, and process metrics.\n\nPresent findings to management and contribute to continuous improvement.\n\nMaintain documentation of audit, procedures, training materials, and process workflows.\n\nQUALIFICATION REQUIREMENTS:\n\nBachelor’s degree or equivalent work experience.\n\n2–4 years of experience in process improvement, operations analysis, or quality improvement.\n\nStrong analytical and problem-solving skills.\n\nProficiency in MS Office, especially Excel (pivot tables, charts, formulas).\n\nExcellent written and verbal communication skills.\n\nAbility to work independently and manage multiple priorities.\n\nPreferred:\n\nExperience in healthcare, workers’ compensation, or bill review operations.\n\nFamiliarity with quality management tools (e.g., root cause analysis, PDCA, Pareto charts).\n\nCertification in Six Sigma, Lean, or ASQ.\n\nParadigm Benefits:\n\nHealth 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).\n\nFinancial 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.\n\nVacation - 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.\n\nVolunteer 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.\n\nLearning 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.\n\nParadigm 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.\n\nParadigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.\n\nWe 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.\n\nAs a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster\n\n#LI-Remote\n\n#J-18808-Ljbffr","datePosted":"2026-09-13T03:52:08.246Z","dateModified":"2026-09-13T03:52:08.246Z","hiringOrganization":{"@type":"Organization","name":"Socket","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Phoenix","addressRegion":"AZ","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"03d4604ee7d7be2cc878743e"},"url":"https://jobsearcher.com/jobs/03d4604ee7d7be2cc878743e"}}