Director – Virtual Utilization Review

🔥 32 minutes ago

🇺🇸 United States – Remote

💵 $101.6k - $142k / year

⏰ Full Time

🔴 Lead

👔 Director

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What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2022-03

Consulting • Insurance • Logistics

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 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 of 125–175 employees globally • Manage and empower at least 3 direct-report leaders • Foster a high-performing culture aligned with organizational values • Travel up to 25%

🎯 Requirements

• Bachelor’s degree or equivalent combination of education and experience • Current RN license • 2+ years of leadership experience in multi-client utilization review / utilization management operations • Experience in Revenue Cycle Management or equivalent healthcare leadership experience • Experience managing geographically dispersed teams across the US and international locations • Demonstrated success in client relationship management and partnership development • Experience driving organizational transformation and leading change management across people, process, and technology • Strong analytical skills and data-driven leadership approach • Proficiency in Power BI preferred • Effective communication skills • Strong technical skills, including database and spreadsheet analysis • Working knowledge of EMR(s) with front- and back-end understanding • Experience with project management tools preferred, such as AHA, Loop, Microsoft Project, or similar • Willingness and ability to travel to and work onsite at client, temporary, or corporate office locations as business needs dictate • Must reside and be authorized to work within the United States

🏖️ Benefits

• Comprehensive healthcare benefits • Paid time off • Retirement benefits • Well-being programs • Professional certification relevant to the associate’s field • Tuition reimbursement • Quarterly and annual incentive programs • Remote work arrangement • Work-life flexibility • Professional development opportunities

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