Director, Virtual Utilization Review

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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 of 125–175 employees globally • Manage and empower direct reports including a minimum of 3 leaders • Foster a high-performing culture aligned with organizational values

🎯 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 • Strategic mindset with experience driving organizational transformation and leading change management initiatives across people, process, and technology • Data-driven leadership approach, with strong analytical skills; proficiency in Power BI (for dashboard navigation and insights) preferred • Effective communication skills with the ability to organize and present information clearly and concisely • Strong technical skills including database and spreadsheet analysis and working knowledge of EMR(s) with front- and back-end understanding • Experience with project management tools preferred (AHA, Loop, Microsoft Project, or similar)

🏖️ Benefits

• healthcare • time off • retirement • well-being programs • professional development • quarterly and annual incentive programs