Senior Level Quality Improvement Specialist Jobs

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 Manager, Client Experience & Continuous Improvement will support the design, execution, and continuous improvement of Paradigm’s centralized issue tracking and management process within Salesforce. This role is responsible for ensuring client issues and requests are accurately triaged, efficiently routed, actively managed, and resolved in a timely manner, while driving visibility into trends, root causes, and systemic improvements.
This is a player-coach role requiring both hands-on execution and strategic leadership, combining operational oversight (intake governance, monitoring, reporting) with ownership of process design, scalability, analytics, and continuous improvement.
In addition, this role will actively support and participate in key Customer Experience (CX) initiatives as determined by the SVP of Customer Experience, contributing to broader efforts to enhance client experience, strengthen cross-functional alignment, and drive enterprise CX maturity.

• This is a hybrid position in the Tampa office location

DUTIES AND RESPONSIBILITIES:
Intake Governance

• Responsible for intake and queue governance for inbound client issues
• Establish and enforce triage standards, SLAs, and governance
• Ensure issues are accurately classified, prioritized, and routed based on defined standards and business impact

Case Monitoring & Resolution Management

• Monitor active issues to ensure timely progress, resolution, and adherence to SLAs and escalation protocols.
• Proactively identify stalled or at-risk cases and intervene
• Partner with Account Management, Operations, and Product teams to remove barriers

Continuous Improvement & Root Cause Resolution

• Identify root causes, recurring trends, and systemic improvement opportunities.
• Ensure accurate documentation and tracking of corrective actions in Salesforce.
• Partner cross-functionally to implement process, workflow, and system improvements.
• Drive scalable solutions that improve efficiency, reduce issue recurrence, and enhance customer outcomes.

Salesforce Process & Reporting Ownership

• Own Salesforce case management design enhancements, including: Fields, workflows, routing rules, and dashboards
• Develop and maintain reporting on issue volume and trends, resolution timeliness, root cause distribution, and repeat issues / systemic defects.
• Leverage issue data to identify emerging risks, inform prioritization, and influence enterprise decision-making
• Translate insights into actionable recommendations for leadership

Rollout & Scaling Across Products

• Lead expansion of issue tracking across additional products and business lines
• Develop standardized onboarding approach for new teams
• Ensure consistency while accommodating product-specific nuances

Metrics, Governance & Executive Reporting

• Define and manage KPIs for issue management performance
• Publish recurring dashboards and executive summaries to stakeholders
• Support CX Council / Steering Committee with insights and recommendations

Training, Adoption & Change Management

• Develop training materials and SOPs for issue management processes
• Lead training sessions for internal teams
• Champion adoption and proper usage of the issue tracking system
• Act as the voice and advocate of the process

Customer Experience (CX) Initiative Support

• Actively participate in and support key CX initiatives as determined by the SVP of Customer Experience
• Contribute to cross-functional CX programs, including, but not limited to, Voice of Customer (VoC), journey mapping, experience improvement initiatives, and customer health and risk identification programs
• Provide issue tracking insights to inform enterprise CX strategy and prioritization
• Partner with CX leadership to ensure alignment between issue management outputs and broader experience transformation goals

Team Leadership (Future-State)

• Build and lead a team of issue management analysts/coordinators
• Establish roles, responsibilities, and performance standards
• Provide coaching and oversight as the function scales.

Operational Expectations & Standards

• Maintain reliable and predictable attendance during scheduled work hours or core business hours.
• Travel occasionally for meetings, training, or business-related activities.
• Utilizes AI tools to support day-to-day tasks, improve efficiency, and enhance output quality. Adopts new technologies as trained and applies them in alignment with established processes and guidelines.
• Demonstrates a customer-first mindset by reinforcing expectations of all employees as drivers of customer excellence by actively fostering engagement, clarity, accountability, and support, recognizing that a positive and consistent employee experience directly influences service quality and customer outcomes.
• Responsible for complying with Paradigm Information Security requirements and policies, for safeguarding Paradigm or Paradigm related passwords, and for notifying Paradigm of any Information Security incidents per policy SEC 10-12 Information Security Incident Management.

QUALIFICATION REQUIREMENTS:
Education

• Bachelor’s degree in Business, Operations Management, Healthcare Administration, Information Systems, or related field required
• Equivalent combination of education and relevant experience will be considered
• Lean / Six Sigma certification (Green Belt preferred)

Experience:

• 7+ years of progressive experience in operations, customer experience, issue/case management, or process improvement role within workers’ compensation
• Demonstrated experience with Salesforce case management (or similar CRM platforms), including reporting and workflow design
• Experience with data visualization tools (e.g., Tableau, Power BI)
• Proven ability to design, implement, and scale operational processes in a cross-functional environment
• Strong analytical skills with the ability to translate data into actionable insights and executive-level reporting
• Experience with root cause analysis and driving continuous improvement initiatives
• Ability to influence and drive accountability across cross-functional teams without direct authority
• Experience leading process adoption, training, and change management initiatives
• Strong organizational and prioritization skills, with the ability to manage multiple priorities and make sound decisions in fast-paced, ambiguous environments
• Excellent communication skills, including the ability to present complex information clearly and concisely to both operational and executive audiences
• Demonstrated critical thinking, problem-solving, and sound judgment, particularly in triage and escalation scenarios
• High level of ownership, accountability, and attention to detail, with a proactive and solution-oriented mindset
• Strong collaboration and relationship-building skills, with a customer-centric approach to problem-solving
• Familiarity with customer experience (CX) concepts such as Voice of Customer (VoC), journey mapping, or customer health metrics
• Experience managing or supporting enterprise initiatives or multi-phase rollouts
• Prior supervisory or team leadership experience required

Core Competencies:

• Operational Execution & Process Management - ability to design, implement, and manage structured workflows, ensuring consistent execution, SLA adherence, and data integrity.
• Analytical Thinking & Insight Generation - ability to analyze data, identify trends and root causes, and translate findings into actionable insights that drive operational and customer experience improvements.
• Continuous Improvement & Problem Solving - applies structured problem-solving approaches to identify systemic issues, reduce repeat defects, and drive sustainable process enhancements.
• Salesforce & Systems Acumen - proficient in leveraging Salesforce (or similar platforms) to support case management, workflow automation, and reporting; able to translate business needs into system solutions.
• Cross-Functional Collaboration & Influence - builds strong partnerships across Operations, IT, Product, and Client-facing teams; effectively drives alignment and accountability without direct authority.
• Customer-Centric Mindset - maintains a strong focus on client experience by connecting issue resolution efforts to broader customer impact and experience improvement opportunities.
• Communication & Executive Presence - communicates clearly and concisely across all levels; able to present complex information in a structured, executive-ready format.
• Change Management & Adoption Leadership - drives adoption of new processes and tools through training, communication, and reinforcement; effectively leads teams through change.
• Ownership & Accountability - takes full ownership of outcomes, proactively identifying risks, driving resolution, and following through on commitments with a high level of accountability.
• Organizational Agility & Prioritization - effectively manages competing priorities, adapts to changing business needs, and maintains focus in a dynamic, evolving environment

Paradigm 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.

Paradigm 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.

Paradigm 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.

We 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.

As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster

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