Director, Virtual Utilization Review

🕒 2 days ago

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 Private Equity Round on 2022-03

Healthcare Insurance • SaaS • Enterprise

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Build strong, trusted relationships with clients and serve as a strategic partner • Develop a deep understanding of client KPIs and SLAs within the first 60 days • Identify and execute proactive opportunities to improve performance, satisfaction, and outcomes • Oversee complex multi-client utilization review and utilization management operations • Drive measurable improvements in performance, productivity, and SLA attainment • Lead data-driven decision-making using dashboards and analytics tools • Champion adoption of new technologies and investment capabilities • Lead large-scale change initiatives across people, process, and technology • Partner cross-functionally to implement process and system improvements • Lead, develop, and mentor a large, multi-layered team (125–175 employees globally) • Manage and empower direct reports (minimum of 3 leaders) • Foster a high-performing culture aligned with organizational values

🎯 Requirements

• Active Registered Nurse (RN) license • Proven experience leading complex, multi-client utilization review / utilization management operations (RPM environment preferred) • Strong background in Revenue Cycle Management (RCM) (or equivalent healthcare leadership experience) • Experience managing multi-geography teams • Demonstrated success in client relationship management and partnership development • Strategic mindset with experience driving organizational transformation • Data-driven leadership approach, with strong analytical skills • Proficiency in Power BI (dashboard navigation and insights) • Working knowledge of EMR systems (Cerner, Epic, or Meditech preferred) with both front- and back-end understanding • Proficiency in Microsoft Office Suite • Experience leading change management initiatives across people, process, and technology

🏖️ Benefits

• Comprehensive benefits package designed to support physical, emotional, and financial health • Healthcare • Time off • Retirement • Well-being programs • Professional development • Professional certification reimbursement • Tuition reimbursement • Quarterly and annual incentive programs